Novel drugs for the management of hepatic encephalopathy: Still a long journey to travel

Rajpurohit, Siddheesh and Musunuri, Balaji and Shailesh, * and Mohan, Pooja Basthi and Shetty, Shiran (2022) Novel drugs for the management of hepatic encephalopathy: Still a long journey to travel. Journal of Clinical and Experimental Hepatology, 12 (4). pp. 1200-1214. ISSN 0973-6883

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Abstract

Hepatic encephalopathy (HE) is one of the reversible complications of chronic liver disease, associated with a higher mortality rate. In current clinical practice, treatment with rifaximin and lactulose/lactitol is the first line of treatment in HE. With the advance in pathophysiology, a new class of ammonia lowering drugs has been revealed to overcome the hurdle and disease burden. The mechanism of the novel agents differs significantly and includes the alteration in intestinal microbiota, intestinal endothelial integrity, oxidative stress, inflammatory markers, and modulation of neurotoxins. Most of the trials have reported promising results in the treatment and prevention of HE with fecal microbiota transplantation, albumin, probiotics, flumazenil, polyethylene glycol, AST-120, glycerol phenylbutyrate, nitazoxanide, branched-chain amino acid, naloxone, and acetyl-L-carnitine. However, their clinical use is limited due to the presence of major drawbacks in their study design, sample size, safety profile, bias, and heterogenicity. This study will discuss the novel therapeutic targets for HE in liver cirrhosis patients with supporting clinical trial data.

Item Type: Article
Uncontrolled Keywords: Hepatic encephalopathy; liver cirrhosis; novel drugs; treatment outcome.
Subjects: Medicine > KMC Manipal > Gastroenterology
Depositing User: KMC Library
Date Deposited: 25 Jul 2022 08:39
Last Modified: 25 Jul 2022 08:39
URI: http://eprints.manipal.edu/id/eprint/159092

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