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News

Rifaximin associated with prolonged overall survival in hepatic encephalopathy

Rifaximin treatment is associated with reduced risk of cirrhotic complications and prolonged overall survival in patients experiencing hepatic encephalopathy, finds November's issue of the Alimentary Pharmacology & Therapeutics.

News image

Rifaximin might decrease the risk of portal hypertension-related complications by controlling small intestinal bacterial overgrowth.

Professor Lee and colleagues from Korea evaluated whether rifaximin was associated with the risk of death and cirrhotic complications.

The researchers conducted a retrospective study that included 1042 patients experiencing hepatic encephalopathy.

The team noted that 421 patients without hepatocellular carcinoma, and 621 patients with HCC.

Rifaximin was associated with lower risk of spontaneous bacterial peritonitis
Alimentary Pharmacology & Therapeutics

The research team's primary endpoint was overall survival and secondary endpoints were recurrence of HE and the development of spontaneous bacterial peritonitis, hepatorenal syndrome and variceal bleeding.

In the non-HCC cohort, 145 patients received rifaximin plus lactulose, and 276 patients received lactulose alone.

The team revealed that rifaximin was significantly associated with lower risk of death, and reduced the risk of recurrent hepatic encephalopathy, spontaneous bacterial peritonitis, and variceal bleeding but not hepatorenal syndrome.

In the HCC cohort, the researchers reported that 173 patients received rifaximin plus lactulose, and 448 patients received lactulose.

The researchers found that rifaximin was not associated with the risk of death.

Rifaximin was associated with lower risk of spontaneous bacterial peritonitis but not with variceal bleeding or recurrent hepatic encephalopathy.

The research team observed that the risk of Clostridium difficile-associated diarrhoea was not different between the groups.

Professor Lee's team commented, "In patients without HCC, rifaximin treatment was significantly associated with prolonged overall survival and reduced risks of spontaneous bacterial peritonitis, variceal bleeding and recurrent hepatic encephalopathy."

Aliment Pharmacol Ther 2017: 46(9): 845–855
25 October 2017

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