Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Pearl Toh, 11 Oct 2017
Clinical practice is an art guided by good science, and clinical practice guideline (CPG) is meant to guide in integrating the art and science of clinical practice for the long-term benefits of patients, said Dr Abdul Rashid Abdul Rahman, a consultant cardiovascular physician at An-Nur Specialist Hospital in Bangi, Malaysia, during the 13th Asian-Pacific Congress of Hypertension (APCH) held in Singapore.
Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute. 

Rifaximin for hepatic encephalopathy may prolong survival in patients without HCC

14 Sep 2017

Rifaximin appears to confer increased survival benefit in hepatic encephalopathy patients without hepatocellular carcinoma (HCC), in addition to reducing the risks of spontaneous bacterial peritonitis, variceal bleeding and recurrent hepatic encephalopathy, according to a study.

To evaluate whether rifaximin was associated with the risk of death and cirrhotic complications, researchers retrospectively examined data from 1,042 patients with hepatic encephalopathy who were grouped into two according to HCC status: HCC (n=621) and non-HCC cohorts (n=421).

Overall survival was the primary endpoint. Recurrence of hepatic encephalopathy and the development of spontaneous bacterial peritonitis, hepatorenal syndrome and variceal bleeding were evaluated as secondary endpoints.

In the non-HCC cohort, 145 patients received rifaximin plus lactulose (the rifaximin group) and 276 received lactulose alone (the control group). On multivariate Cox proportional hazards analysis, rifaximin had a protective effect on the risks of death (adjusted hazard ratio [aHR], 0.697; p=0.024), recurrent hepatic encephalopathy (aHR, 0.452; p<0.001), spontaneous bacterial peritonitis (aHR, 0.210; p<0.001) and variceal bleeding (aHR, 0.425; p=0.011) but not on hepatorenal syndrome (aHR, 0.598; p=0.08).

In the HCC cohort, there were 173 patients in the rifaximin group and 448 patients in the control group. Rifaximin reduced the risk of developing spontaneous bacterial peritonitis (aHR, 0.323; p<0.001); no association was observed for the risk of death (aHR, 1.177; p=0.121), variceal bleeding (aHR, 0.660; p=0.104) or recurrent hepatic encephalopathy (aHR, 0.689; p=0.057). The risk of Clostridium difficile-associated diarrhoea did not differ between the rifaximin and control groups (aHR, 0.028; p=0.338).

“Although rifaximin was not associated with lower risk of death in patients with HCC, it has been shown to be related to preventing portal hypertension-related complications. Th[e] present study may support the initiation of a large cohort study to assess the overall efficacy of rifaximin in patients with previous hepatic encephalopathy,” researchers said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Pharmacy - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
01 Oct 2013

Heart disease is still New Zealand’s biggest killer, with one Kiwi dying from coronary heart disease every 90 minutes. Pharmacy Today New Zealand looks at how pharmacists can help

Pearl Toh, 11 Oct 2017
Clinical practice is an art guided by good science, and clinical practice guideline (CPG) is meant to guide in integrating the art and science of clinical practice for the long-term benefits of patients, said Dr Abdul Rashid Abdul Rahman, a consultant cardiovascular physician at An-Nur Specialist Hospital in Bangi, Malaysia, during the 13th Asian-Pacific Congress of Hypertension (APCH) held in Singapore.
Dr. James Salisi, 01 Jul 2014

The recent spike in the number of new cases of human immunodeficiency virus (HIV) infection in the Philippines means that clinicians and pharmacists alike may need to increase their awareness and competency in prescribing and monitoring HIV treatment. Although taught in medical and pharmacy schools, the scarcity in exposure to clinical cases before highlights the need to for physicians and pharmacist to review HIV pharmacotherapy in order to cater to the increasing HIV patient population.

01 Sep 2017
Complementary medicines can play an important part in maintaining wellness, preventing deficiencies and optimizing health outcomes, says Dr Lesley Braun PhD, Director of the Blackmores Institute.