Intervention Review

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Dopamine agents for hepatic encephalopathy

  1. Anders Ellekær Junker1,*,
  2. Bodil Als-Nielsen2,
  3. Christian Gluud3,
  4. Lise Lotte Gluud4

Editorial Group: Cochrane Hepato-Biliary Group

Published Online: 10 FEB 2014

Assessed as up-to-date: 13 JAN 2014

DOI: 10.1002/14651858.CD003047.pub3


How to Cite

Junker AE, Als-Nielsen B, Gluud C, Gluud LL. Dopamine agents for hepatic encephalopathy. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD003047. DOI: 10.1002/14651858.CD003047.pub3.

Author Information

  1. 1

    Gentofte Hospital, Department of Medicine F, Hellerup, Denmark

  2. 2

    The Child and Youth Clinic, Department of Paediatric Haematology/Oncology (5054), Copenhagen, Denmark

  3. 3

    Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University Hospital, The Cochrane Hepato-Biliary Group, Copenhagen, Denmark

  4. 4

    Copenhagen University Hospital Hvidovre, Gastro Unit, Medical Division, Hvidovre, Denmark

*Anders Ellekær Junker, Department of Medicine F, Gentofte Hospital, Niels Andersens Vej 65, Hellerup, 2900, Denmark. andjunker@dadlnet.dk.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 10 FEB 2014

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[Figure 1]
Figure 1. Figure 1. Study flow diagram.
[Figure 2]
Figure 2. Figure 2. Risk of bias graph: review authors' judgements about all risk of bias items presented as percentages across all included studies.
[Figure 3]
Figure 3. Trial sequential analysis of dopamine agents versus placebo or no intervention in participants with hepatic encephalopathy. The outcome measure is mortality. The analysis was performed with an event rate of 54% (Pc) in the control group, a risk ratio (RR) reduction of 20%, alpha 5%, beta 20%, and diversity 0%. The cumulative Z-curve does not cross the naive 5% statistical boundaries (dotted horizontal lines) or the trial sequential boundaries for benefits or harms (inward sloping etched lines). The results show that the diversity-adjusted required information size was 673 participants, corresponding to 21% of the total sample size in the included trials. The programme did not even draw futility boundaries. Accordingly, the meta-analysis does not recommend or refute an intervention effect; data are simply too few.
[Analysis 1.1]
Analysis 1.1. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 1 Mortality.
[Analysis 1.2]
Analysis 1.2. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 2 Mortality stratified by type of hepatic encephalopathy.
[Analysis 1.3]
Analysis 1.3. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 3 Mortality stratified by liver disease.
[Analysis 1.4]
Analysis 1.4. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 4 Mortality stratified by intervention.
[Analysis 1.5]
Analysis 1.5. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 5 Mortality stratified by bias risk.
[Analysis 1.6]
Analysis 1.6. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 6 Mortality stratified by trial design.
[Analysis 1.7]
Analysis 1.7. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 7 Hepatic encephalopathy.
[Analysis 1.8]
Analysis 1.8. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 8 Hepatic encephalopathy paired data.
[Analysis 1.9]
Analysis 1.9. Comparison 1 Dopamine agonists versus placebo or no intervention, Outcome 9 Adverse events paired data.