In this study, published in the January issue of the Journal of Hepatology, researchers assessed the efficacy and safety of rifaximin, compared to lactitol, in the treatment of acute hepatic encephalopathy.
The team performed a prospective randomized, double-blind, double-dummy, controlled trial.
A total of 103 patients with grade I-III acute hepatic encephalopathy were randomized to receive rifaximin or lactitol for 5 to 10 days.
The researchers measured changes in the portal-systemic encephalopathy (PSE) index on entry, and at the end of the study, to evaluate the efficacy of the 2 therapies.
Both patient groups were comparable before treatment, with regard to demographic data, and characteristics of the hepatic encephalopathy episode.
|A significantly better evolution of the PSE index was observed in the rifaximin group.|
|Journal of Hepatology|
The team found that the global efficacy of both therapies was similar.
The percentage of patients showing improvement or episode regression was 82% in the rifaximin group, and 80% in the lactitol group.
The team observed a significantly better evolution of the PSE index in the rifaximin group. This was due to a greater effect of rifaximin on 2 components of the index: EEG abnormalities and ammonia levels.
No serious adverse events related to either treatment were found during the study.
Dr Antoni Mas’s team concluded, “Rifaximin may be considered a useful and safe alternative therapy to lactitol in the treatment of acute hepatic encephalopathy in cirrhosis”.