Hepatic encephalopathy

Summary

Hepatic encephalopathy (MONDO:0001711) is a disease and 182 clinical trials. Top therapeutic interventions include lactulose, rifaximin, and albumin human. A subtype of toxic encephalopathy — broader associated-gene and molecular evidence is on the parent page (see Disease family below).

At a glance

• Clinical trials: 182

Clinical features

No curated clinical features (Orphanet) for this disease.

Identifiers

Disease identifiers

Field	Value
Canonical name	hepatic encephalopathy
Mondo ID	MONDO:0001711
MeSH	D006501
DOID	DOID:13413
ICD-11	1769383160
NCIT	C79596
SNOMED CT	13920009
UMLS	C0019151
MedGen	5513
GARD	0027587
Is cancer (heuristic)	no

Also known as: encephalopathy, hepatic · Hepatoencephalopathy · portal-systemic encephalopathy

Disease family

This is a subtype of toxic encephalopathy. Genetic, therapeutic, and trial evidence is largely curated at the broader-term level — see the parent page for the associated-gene cohort and molecular evidence.

Classification path: disease › human disease › disease by body system or component › nervous system disorder › toxic encephalopathy › hepatic encephalopathy

Related subtypes (4): carbon monoxide-induced delayed encephalopathy, manganese poisoning, Minamata disease, chronic bilirubin encephalopathy

Subtypes (1): hepatic coma

Genetics & variants

GWAS landscape

No GWAS associations recorded — common-variant (GWAS) studies don’t cover this disease (typical for Mendelian / rare diseases). See the curated gene cohort and Mendelian overlap below.

Variant details and genetic-evidence tiers

No tiered GWAS variants or ClinVar records for this disease.

Genes & proteins

No associated-gene cohort resolved for this disease. Atlas builds the molecular and therapeutic sections — associated genes, protein families, druggability, pathways, interactions, and drug associations — by aggregating over a disease’s associated genes (resolved via GWAS / GenCC / ClinVar / CIViC), and none resolved here. This is expected for antibody-mediated, autoimmune, or otherwise non-gene-defined conditions; the curated evidence for this disease is its clinical features, GWAS susceptibility, and clinical trials (above).

Function

No pathway enrichment — requires an associated-gene cohort.

Therapeutics

Drugs indicated or in trials for this disease

1 approved drug — disease-direct ChEMBL indications, not inferred from the associated-gene cohort below.

Drug	Status
Rifaximin	Approved (phase 4)

Clinical trials & evidence

Clinical trials

Clinical trials: 182.

Phase distribution (across all retrieved trials)

Phase	Trials
Not specified	95
PHASE4	31
PHASE2	22
PHASE3	15
PHASE1	7
PHASE1/PHASE2	6
PHASE2/PHASE3	4
EARLY_PHASE1	2

Top trials by phase / activity

NCT	Phase	Status	Title
NCT04073290	PHASE4	RECRUITING	Prevention of Post-TIPS Hepatic Encephalopathy by Administration of Rifaximin and Lactulose
NCT06538077	PHASE4	RECRUITING	BCAA vs. Rifaximin in Patients With Cirrhosis for Secondary Prophylaxis of HE
NCT06808074	PHASE4	RECRUITING	A Study to Evaluate Role of Inhaled Amikacin to Prevent Ventilator Associated Pneumonia in Patients With Cirrhosis
NCT07521332	PHASE4	RECRUITING	Apixaban-PK Trial: Preventing Portal Hypertension Complications in Cirrhosis
NCT00375375	PHASE4	COMPLETED	Effect of Lactulose on Minimal Hepatic Encephalopathy and Health-Related Quality of Life
NCT00740142	PHASE4	COMPLETED	Efficacy of Combined Oral L-ornithine-L-aspartate and Lactulose in Patients With Hepatic Encephalopathy
NCT00839358	PHASE4	COMPLETED	Effect of Midodrine and Albumine in the Prevention of Complications in Cirrhotic Patients Awaiting Liver Transplantation
NCT00886925	PHASE4	COMPLETED	Efficacy of Albumin for Acute Encephalopathy in Patients With Cirrhosis
NCT00896831	PHASE4	UNKNOWN	Therapeutic Efficacy of Oral L-Ornithine-L-Aspartate on Minimal Encephalopathy
NCT00955500	PHASE4	COMPLETED	Effects of Proteins in Patients With Cirrhosis and Prior Hepatic Encephalopathy
NCT01041755	PHASE4	COMPLETED	Efficacy of L-Ornithine L-Aspartate in Acute Hepatic Encephalopathy.
NCT01059396	PHASE4	COMPLETED	Study on B-blockers to Prevent Decompensation of Cirrhosis With HTPortal
NCT01175538	PHASE4	UNKNOWN	Primary Prophylaxis of Hepatic Encephalopathy in Patients With Cirrhosis
NCT01178372	PHASE4	UNKNOWN	Secondary Prophylaxis of Hepatic Encephalopathy in Cirrhosis
NCT01356121	PHASE4	UNKNOWN	Trial Comparing Sedation for Endoscopy With Propofol Versus Midazolam in Cirrhotics
NCT01559519	PHASE4	COMPLETED	Post Transjugular Intrahepatic Portosystemic Shunt (Tips) Albumine Infusion to Prevent Hepatic Encephalopathy
NCT01722578	PHASE4	COMPLETED	L-ornithine L-aspartate in Overt Hepatic Encephalopathy
NCT01842113	PHASE4	TERMINATED	Quality of Life and Nutritional Improvements in Cirrhotic Patients
NCT01842581	PHASE4	COMPLETED	The Safety/Efficacy of Rifaximin With/Without Lactulose in Participants With A History of Recurrent Hepatic Encephalopathy
NCT01846663	PHASE4	TERMINATED	Efficacy, Safety, And Pharmacokinetics Of Rifaximin In Subjects With Severe Hepatic Impairment And Hepatic Encephalopathy
NCT01847651	PHASE4	COMPLETED	Brain Muscle Axis During Treatment of Hepatic Encephalopathy With L-ornithine L-aspartate
NCT02158182	PHASE4	COMPLETED	Lactulose, L-ornithine L-aspartate, or Rifaximin Versus Placebo for Preventing Hepatic Encephalopathy in Variceal Bleeding
NCT02401490	PHASE4	UNKNOWN	Albumin Infusion Effects in Mortality in Patients With Cirrhosis and Hepatic Encephalopathy
NCT02470546	PHASE4	UNKNOWN	Metformin Experience on Minimal Hepatic Encephalopathy
NCT03100513	PHASE4	UNKNOWN	PEG (Polyethylene Glycol)Versus Lactulose For Treatment Of Overt Hepatic Encephalopathy
NCT03987893	PHASE4	UNKNOWN	PEG3350 in ACLF With Hepatic Encephalopathy
NCT04436601	PHASE4	UNKNOWN	Polyethylene Glycol Versus Lactulose on Hepatic Encephalopathy in Patients With Cirrhosis;(PEGHE Trial)
NCT04736836	PHASE4	COMPLETED	Microbial Resistance of Rifaximin in Hepatic Encephalopathy
NCT05539027	PHASE4	COMPLETED	Efficacy of L-Ornithine L-Aspartate (LOLA) as an Adjunct to Branched Chain Amino Acids (BCAA) Enriched Solutions on Clinical Outcomes in ICU Patients With Hepatic Encephalopathy
NCT05788627	PHASE4	UNKNOWN	Effectiveness of Oral Lactulose Versus Lactulose Enema in Hepatic Encephalopathy
NCT05920213	PHASE4	UNKNOWN	Efficacy of L-Ornithine L-Aspartate and Polyethylene Glycol in Cirrhotic Patients With Overt Hepatic Encephalopathy
NCT04161053	PHASE3	RECRUITING	Efficacy and Safety of Nitazoxanide in Preventing Recurrence of Hepatic Encephalopathy
NCT05071716	PHASE3	ACTIVE_NOT_RECRUITING	Study to Assess Rifaximin Soluble Solid Dispersion (SSD) for the Delay of Encephalopathy Decompensation in Cirrhosis
NCT05297448	PHASE3	ACTIVE_NOT_RECRUITING	Evaluation of Rifaximin SSD for Delaying Encephalopathy Decompensation in Patients With Cirrhosis
NCT00248625	PHASE3	COMPLETED	N-acetylcysteine in Non-Acetaminophen Pediatric Acute Liver Failure
NCT00298038	PHASE3	COMPLETED	A 6-month Efficacy, Safety, and Tolerability Study of Rifaximin In Preventing Hepatic Encephalopathy
NCT00364689	PHASE3	TERMINATED	RICE Trial: Rifaximin In Chronic Hepatic Encephalopathy - A Randomized, Controlled Trial
NCT00433368	PHASE3	COMPLETED	Efficacy of L-Ornithine-L-Aspartate in Cirrhotics With Hepatic Encephalopathy
NCT00553423	PHASE3	UNKNOWN	Lactulose for the Prevention of Hepatic Encephalopathy in Cirrhotic Patients With Upper Gastrointestinal Hemorrhage
NCT00686920	PHASE3	COMPLETED	Safety and Tolerability Study of Rifaximin in Participants With a History of Hepatic Encephalopathy

Drugs tested across these trials (top 30)

Molecule	Max phase	Trials referencing
LACTULOSE	4	35
RIFAXIMIN	4	15
ALBUMIN HUMAN	4	5
NITAZOXANIDE	4	3
PROPRANOLOL	4	3
CARVEDILOL	4	2
GLYCEROL PHENYLBUTYRATE	4	2
THIAMINE ION	4	2
ACETYLCYSTEINE	4	1
ALLOPURINOL	4	1
AMIKACIN	4	1
APIXABAN	4	1
COLISTIMETHATE SODIUM	4	1
COLISTIN	4	1
DIPHENHYDRAMINE	4	1
ERYTHROMYCIN	4	1
FLUMAZENIL	4	1
GLUTAMINE	4	1
LEMBOREXANT	4	1
MIDAZOLAM	4	1
MIDODRINE	4	1
NEOMYCIN	4	1
POLYETHYLENE GLYCOL 3350	4	1
PROPOFOL	4	1
TOLVAPTAN	4	1
ORNITHINE	3	6
ASPARTIC ACID	3	5
POLYETHYLENE GLYCOL	3	4
ACETYLCARNITINE	3	2
CHARCOAL, ACTIVATED	3	2