Prognosis and safety of long-term oral branched-chain amino acids for cirrhosis: a meta-analysis

Abstract

Objective To evaluate the prognosis and safety of long-term oral Branched-Chain Amino Acids (BCAAs) for patients with cirrhosis.Methods Randomized controlled trials (RCTs) were identified from CBM (between January 1978 and September 2013),CNKI (between January 1979 and September 2013),PubMed (between January 1970 and September 2013),EMBASE (between January 1970 and September 2013),and Cochrane Library (issue 4,2013).Publications of the RCTs on the treatment of cirrhosis with oral BCAAS were included and analyzed according to the criteria of Cocbrane handbook.Results Six RCTs involving 1 047 patients were included.The results showed that oral BCAAs improved the event-free survival when compared with the control group [RR =1.13,95％ CI =(1.05,1.23),P =0.001].BCAAs supplements had no effect on mortality or had no definite effect on the deteriorative rate of minimal hepatic encephalopathy (MHE) or quality of life (QOL).As reported in some trials,the main side effects of BCAAs were gastrointestinal symptoms.Conclusions Long-term oral BCAAs may improve event-free survival in cirrhotic patients.However,no definite conclusion can be made without evidences from larger,randomized,double-blind,placebo-controlled,and multicenter trials. Key words: Branched-chain amino acid; Cirrhosis; Minimal hepatic encephalopathy; Randomized controlled trials; Meta-analysis