Naloxone in the management of hepatic encephalopathy

BACKGROUND/AIM: This study aimed to assess the effectiveness and safety of naloxone in the management of hepatic encephalopathy (HE). METHODS: Cochrane collaboration methodology was used in a meta-analysis of randomized controlled trials of naloxone therapy for HE. RESULTS: Seventeen randomized trials were identified with 15 studies involving 1054 patients meeting criteria for inclusion. Naloxone use was associated with a significant improvement in HE [relative risk (RR) 1.46; 95% confidence interval (CI) 1.27-1.67; P = 0.0005]. This comparison showed statistical heterogeneity (P < 0.10, and χ2 = 44.93). Subgroup analysis indicated naloxone administered parenterally by intermittent or continuous infusions to be effective (RR 1.34; 95% CI 1.17-1.53; P < 0.0001). A significant in trials by infusion route (RR 1.42; 95% CI 1.19-1.69; P < 0.0001) interaction was observed. CONCLUSIONS: Naloxone may improve HE. However, published data are limited.