If the data were likely to be normally distributed, we used the median for meta‐analysis when the mean was not available; otherwise, we planned to simply provide a median and an interquartile range of the difference in medians. e. log odds ratio for binary outcomes, mean difference or standardised mean difference for continuous outcomes, log rate ratio for count outcomes, and log hazard ratio for time‐to‐event outcomes) for any two interventions ('functional parameters') as a function of comparison between each individual intervention and the reference group ('basic parameters') using appropriate likelihood functions and links ( Lu 2006). Non‐alcoholic fatty liver disease (NAFLD) is an accumulation of fat in the liver of people who have no history of significant alcohol consumption, use of medicines, disease such as hepatitis C virus infection, or other conditions such as starvation that can damage the liver.

Non‐alcohol‐related fatty liver disease is currently one of the most common reasons for liver transplantation: from 2008, NAFLD was the second or third most common reason for liver transplantation each year; the number of people who underwent liver transplantation was similar to the number with alcohol‐related liver disease since 2008 ( Cholankeril 2017).We estimated the ranking probabilities for all interventions of being at each possible rank for each intervention for each outcome when NMA (network meta‐analysis) was performed. We considered variations in sub‐categories, for example, different doses or durations of nutritional supplementation, as the same treatment node. Phosphatidylcholine improves the absorption of silybine and thus promotes the natural regeneration of the liver. We propose registry‐based randomised clinical trials or cohort multiple randomised clinical trials (study design in which multiple interventions are trialed within large longitudinal cohorts of patients to gain efficiencies and align trials more closely to standard clinical practice) comparing interventions such as vitamin E, prebiotics/probiotics/synbiotics, PUFAs, and no nutritional supplementation.

In all, 48 trials were at low risk of selective outcome reporting bias, as the important clinical outcomes expected to be reported in such trials were reported; the remaining 154 trials were at high risk of selective outcome reporting bias as outcomes were changed from the protocol published prior to recruitment without sufficient justification, or trials did not report reasonably expected clinical outcomes if no protocol was published prior to recruitment. The weighted median control group proportion shown in this table was from the only study in which a formal analysis was performed.

If there was any doubt as to whether trials shared the same participants, completely or partially (by identifying common authors and centres), we planned to contact trial authors to clarify whether the trial report was duplicated. HEPAGUARD is therefore indicated in the treatment of all conditions associated with hepatic failure.

gov (n = 393), World Health Organization (WHO) Trials register (n = 19), FDA (n = 137), and EMA (n = 131). For all direct comparisons and for network meta‐analysis involving clinical outcomes, events were fewer than 300, and we downgraded one level for imprecision. g. number of serious adverse events or number of any adverse events), we calculated the rate ratio (RaR) with 95% Crl. We evaluated the plausibility of the network meta‐analysis transitivity assumption by looking at inclusion and exclusion criteria in all studies.If that cell is empty, look at the column corresponding to intervention B and the row corresponding to intervention A.

We listed the records that we excluded and the reasons for their exclusion in the Characteristics of excluded studies table. A total of 52 trials (3372 participants) reported mortality at maximal follow‐up of 2 to 28 months ( Wang 2008; Gomez 2009; Sanyal 2010; Vajro 2011; Malaguarnera 2012; Illnait 2013; Magosso 2013; Nobili 2013; Shavakhi 2013; Wong 2013a; Chachay 2014; Foroughi 2014; Sanyal 2014; Scorletti 2014; Somi 2014; Aller 2015; Bae 2015; Chen 2015a; Dasarathy 2015; Zhang 2015; Ferolla 2016; Heeboll 2016; Li 2016; Nabavi 2016; Yari 2016; Chan 2017; Famouri 2017a; Hussain 2017; Manzhalii 2017; Sakpal 2017; Schattenberg 2017; Shahmohammadi 2017; Bakhshimoghaddam 2018; Eriksson 2018; Kobyliak 2018; Lewis 2018; Oscarsson 2018; Taghvaei 2018; Zamani 2018; Bril 2019; Cheraghpour 2019; Duseja 2019; Jazayeri‐Tehrani 2019; Abhari 2020; Afzali 2020; Boonyagard 2020; Mansour 2020; Poparn 2020; Scorletti 2020; Yari 2020; Soleimani 2021; EUCTR 2008‐008275‐34‐GB). BioCare Antioxidant Complex has recently been re-formulated with increased levels of green tea, turmeric and Vitaflavan® grapeseed extract, alongside other potent phytonutrients such as quercetin, lycopene, lutein and high strength bilberry extract.Choline is an essential phospholipid which supports liver function and lipid metabolism, whilst artichoke and milk thistle are potent herbs which aid digestion (especially of fats), detoxification, and liver and gallbladder health. The evidence is very uncertain about effects of interventions in any of the remaining comparisons, or data were sparse (with zero events in at least one of the groups), precluding formal calculations of effect estimates. Accordingly, high‐quality randomised comparative clinical trials with adequate follow‐up are needed. We excluded from network meta‐analysis any trials that were not connected to the network, and we reported only the direct pairwise meta‐analysis for such comparisons.