Affiliation:
1. School of Public Health Fudan University Shanghai China
2. Key Laboratory of Public Health Safety, Ministry of Education Fudan University Shanghai China
3. Fudan University Center for Tropical Disease Research Shanghai China
4. Department of Reference Medical Library of Fudan University Shanghai China
5. Department of Gastroenterology The Third People's Hospital of Hunan Yueyang China
6. School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa Ottawa Canada
Abstract
AbstractBackground and AimMicrobiome‐targeted therapies (MTTs) are considered as promising interventions for cirrhosis, but the impact of gut microbiome modulation on liver function and disease severity has not been fully assessed. We comprehensively evaluated the efficacy of MTTs in patients with liver cirrhosis.MethodsData from randomized controlled trials were collected through MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrial.gov from inception to February 20, 2023. Clinical outcomes were pooled and expressed in terms of risk ratios or mean differences (MD). Additional subgroup and sensitivity analyses were performed to validate the robustness of findings. A trial sequential analysis was applied to calculate the required information size and evaluate the credibility of the meta‐analysis results.ResultsTwenty‐one studies with a total of 1699 cirrhotic patients were included for meta‐analysis. MTTs were associated with a significant reduction in aspartate aminotransferase (MD, −3.62; 95% CI, −6.59 to −0.65), the risk of hepatic encephalopathy (risk ratio = 0.56, 95% CI: 0.46 to 0.68), model for end‐stage liver disease score (MD, −0.90; 95% CI, −1.17 to −0.11), ammonia (MD, −11.86; 95% CI, −16.39 to −7.33), and endotoxin (MD, −0.14; 95% CI, −0.23 to −0.04). The trial sequential analysis yielded reliable results of these outcomes. No effects were observed on the changes of other hepatic function indicators.ConclusionMTTs appeared to be associated with a slowed deterioration in liver cirrhosis, which could provide reference for clinicians in treatment of cirrhotic patients based on their conditions.
Subject
Gastroenterology,Hepatology