Most Read Articles
01 Sep 2016
Digoxin, as a new or preexisting therapy, does not increase mortality following acute phase of ST-elevation myocardial infarction (STEMI), as shown in the MAGIC study.
15 Apr 2016
Addition of digoxin to an ACE inhibitor lessens heart failure (HF) hospitalisation in HF patients with reduced ejection fraction, regardless of diabetes status, as presented in an analysis of the Digitalis Investigation Group trial.
02 Aug 2017
Inappropriate prescription of anaerobic antibiotics to intensive care unit (ICU) patients admitted with pneumonia frequently occurs, with the prescription associated with prolonged length of stay (LOS) in the ICU, a study has found.
Pearl Toh, 01 Aug 2017
Daily intake of B vitamins did not improve cognitive function in patients with small vessel disease, in addition to previous findings that it was not protective against major vascular events in patients who had a recent stroke or transient ischaemic attack, according to a substudy of the VITATOPS* trial.

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.

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Most Read Articles
01 Sep 2016
Digoxin, as a new or preexisting therapy, does not increase mortality following acute phase of ST-elevation myocardial infarction (STEMI), as shown in the MAGIC study.
15 Apr 2016
Addition of digoxin to an ACE inhibitor lessens heart failure (HF) hospitalisation in HF patients with reduced ejection fraction, regardless of diabetes status, as presented in an analysis of the Digitalis Investigation Group trial.
02 Aug 2017
Inappropriate prescription of anaerobic antibiotics to intensive care unit (ICU) patients admitted with pneumonia frequently occurs, with the prescription associated with prolonged length of stay (LOS) in the ICU, a study has found.
Pearl Toh, 01 Aug 2017
Daily intake of B vitamins did not improve cognitive function in patients with small vessel disease, in addition to previous findings that it was not protective against major vascular events in patients who had a recent stroke or transient ischaemic attack, according to a substudy of the VITATOPS* trial.