Branched-chain amino acids for people with hepatic encephalopathy.

Study answer

What this study found

Branched-chain amino acids improved hepatic encephalopathy overall, but did not reduce mortality and did not show clear benefit for quality of life or nutritional outcomes. In pooled analysis, hepatic encephalopathy improved with BCAA versus control (RR 0.73, 95% CI 0.61 to 0.88; 827 participants; 16 trials), while mortality was unchanged (RR 0.88, 95% CI 0.69 to 1.11; 760 participants; 15 trials). Oral BCAA showed benefit for hepatic encephalopathy (RR 0.67, 95% CI 0.52 to 0.88; 430 participants), whereas intravenous BCAA did not show a clear effect (RR 0.81, 95% CI 0.61 to 1.08; 397…

Study & population

Systematic review and meta-analysis of randomized trials in people with hepatic encephalopathy, including both overt and minimal disease, most commonly due to cirrhosis.

Intervention

Across the included trials, branched-chain amino acids (BCAA) were administered as oral, enteral, or intravenous supplements at varying doses, including fixed doses such as 7.2-29 g/day and 12-40 g/day, or weight-based regimens such as 0.25 g/kg/day and 1.2-1.5 g/kg/day.

Key limitation

The evidence base was heterogeneous, with widely varying BCAA doses, routes, durations, and control conditions across trials.

View full study detailsView sourceOpen PDF

Original abstract