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Digestive Diseases and Sciences

, Volume 38, Issue 5, pp 916–922 | Cite as

Lactitol in treatment of chronic hepatic encephalopathy

A meta-analysis
  • Calogero Cammà
  • Felice Fiorello
  • Fabio Tinè
  • Giulio Marchesini
  • Andrea Fabbri
  • Luigi Pagliaro
Original Articles

Abstract

The efficacy and side effects of lactitol in the treatment of chronic hepatic encephalopathy was compared to that of other disaccharides in a meta-analysis of published randomized clinical trials (RCTs). The outcomes assessed were: (1) the rate of patients free from episodes of clinically detectable encephalopathy, and (2) the rate of patients free from one or more side effects in the different treatment groups. Four RCTs were eligible for analysis; in three lactitol was compared to lactulose, in one the alternative treatment was lactose in lactase-deficient patients. The methodological quality of these studies was high. Meta-analysis showed that lactitol was as effective as other disaccharides in the treatment of encephalopathy: pooled odds ratio was 0.83, 95% confidence interval was 0.38–1.82. Results were not sensitive to the use of alternative methods of counting and attributing events in these trials. Patients experienced fewer side effects during treatment with lactitol, but the pooled odds ratio was not statistically significant. In all studies lactitol was considered more palatable. Clinical effectiveness of lactitol, in long-term treatment of chronic encephalopathy, is similar to those of lactulose. It seems that lactitol has lower side effects than lactulose. Future RCTs with a double-blind design could be mainly aimed at evaluating the side-effect profile of the two disaccharides.

Key words

lactitol lactulose chronic hepatic encephalopathy meta-analysis 

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Copyright information

© Plenum Publishing Corporation 1993

Authors and Affiliations

  • Calogero Cammà
    • 1
    • 2
  • Felice Fiorello
    • 1
    • 2
  • Fabio Tinè
    • 1
    • 2
  • Giulio Marchesini
    • 1
    • 2
  • Andrea Fabbri
    • 1
    • 2
  • Luigi Pagliaro
    • 1
    • 2
  1. 1.Istituto di Medicina Generale e Pneumologia, Clinica Medica R, Ospedale V. CervelloUniversity of PalermoPalermoItaly
  2. 2.Istituto di Clinica Medica Generale e Terapia MedicaUniversity of BolognaBolognaItaly

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