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Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II)

OBJECTIVE: To describe survival of patients with hepatic encephalopathy (HE), up to 5 years after initiation of rifaximin-α (RFX) treatment. DESIGN/METHOD: A retrospective, observational extension study within 9 National Health Service secondary/tertiary UK care centres. All patients had a clinical...

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Autores principales: Aspinall, Richard J, Hudson, Mark, Ryder, Stephen D, Richardson, Paul, Farrington, Elizabeth, Wright, Mark, Przemioslo, Robert T, Perez, Francisco, Kent, Melanie, Henrar, Roland, Hickey, Joe, Shawcross, Debbie L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10086718/
https://www.ncbi.nlm.nih.gov/pubmed/37056320
http://dx.doi.org/10.1136/flgastro-2022-102221
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author Aspinall, Richard J
Hudson, Mark
Ryder, Stephen D
Richardson, Paul
Farrington, Elizabeth
Wright, Mark
Przemioslo, Robert T
Perez, Francisco
Kent, Melanie
Henrar, Roland
Hickey, Joe
Shawcross, Debbie L
author_facet Aspinall, Richard J
Hudson, Mark
Ryder, Stephen D
Richardson, Paul
Farrington, Elizabeth
Wright, Mark
Przemioslo, Robert T
Perez, Francisco
Kent, Melanie
Henrar, Roland
Hickey, Joe
Shawcross, Debbie L
author_sort Aspinall, Richard J
collection PubMed
description OBJECTIVE: To describe survival of patients with hepatic encephalopathy (HE), up to 5 years after initiation of rifaximin-α (RFX) treatment. DESIGN/METHOD: A retrospective, observational extension study within 9 National Health Service secondary/tertiary UK care centres. All patients had a clinical diagnosis of HE, were being treated with RFX and were included in the previous IMPRESS study which reported the 1-year experience. Demographics, clinical outcomes, selected cirrhosis-related complications, hospital admissions and attendances up to 5 years from RFX initiation were extracted from patient medical records and hospital electronic databases. The primary outcome measure was survival at 5 years post-initiation of RFX treatment. RESULTS: The study included 138 patients. The survival rate at 5 years post-initiation of RFX was 35% (95% CI 28.2% to 44.4%) overall and 36% (95% CI 26.1% to 45.4%) for patients with alcohol-related liver disease. Median survival from RFX initiation was 2.8 years (95% CI 2.0 to 3.8; n=136). Among 48 patients alive at 5 years, 69% remained on RFX treatment at the end of the observation period, 74% reported no cirrhosis-related complications and 24% (9/37) had received a liver transplant. Between 1 and 5 years post-initiation, total numbers of liver-related emergency department visits, inpatient admissions, intensive care unit admissions and outpatient visits were 84, 194, 3 and 709, respectively; the liver-related 30-day readmission rate was 37%. CONCLUSION: Within UK clinical practice, RFX use in HE was associated with a 35% survival rate with high treatment adherence, 76% transplant-free survival rate, minimal healthcare resource and low rates of complications at 5 years post-initiation.
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spelling pubmed-100867182023-04-12 Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II) Aspinall, Richard J Hudson, Mark Ryder, Stephen D Richardson, Paul Farrington, Elizabeth Wright, Mark Przemioslo, Robert T Perez, Francisco Kent, Melanie Henrar, Roland Hickey, Joe Shawcross, Debbie L Frontline Gastroenterol Liver OBJECTIVE: To describe survival of patients with hepatic encephalopathy (HE), up to 5 years after initiation of rifaximin-α (RFX) treatment. DESIGN/METHOD: A retrospective, observational extension study within 9 National Health Service secondary/tertiary UK care centres. All patients had a clinical diagnosis of HE, were being treated with RFX and were included in the previous IMPRESS study which reported the 1-year experience. Demographics, clinical outcomes, selected cirrhosis-related complications, hospital admissions and attendances up to 5 years from RFX initiation were extracted from patient medical records and hospital electronic databases. The primary outcome measure was survival at 5 years post-initiation of RFX treatment. RESULTS: The study included 138 patients. The survival rate at 5 years post-initiation of RFX was 35% (95% CI 28.2% to 44.4%) overall and 36% (95% CI 26.1% to 45.4%) for patients with alcohol-related liver disease. Median survival from RFX initiation was 2.8 years (95% CI 2.0 to 3.8; n=136). Among 48 patients alive at 5 years, 69% remained on RFX treatment at the end of the observation period, 74% reported no cirrhosis-related complications and 24% (9/37) had received a liver transplant. Between 1 and 5 years post-initiation, total numbers of liver-related emergency department visits, inpatient admissions, intensive care unit admissions and outpatient visits were 84, 194, 3 and 709, respectively; the liver-related 30-day readmission rate was 37%. CONCLUSION: Within UK clinical practice, RFX use in HE was associated with a 35% survival rate with high treatment adherence, 76% transplant-free survival rate, minimal healthcare resource and low rates of complications at 5 years post-initiation. BMJ Publishing Group 2022-11-10 /pmc/articles/PMC10086718/ /pubmed/37056320 http://dx.doi.org/10.1136/flgastro-2022-102221 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Liver
Aspinall, Richard J
Hudson, Mark
Ryder, Stephen D
Richardson, Paul
Farrington, Elizabeth
Wright, Mark
Przemioslo, Robert T
Perez, Francisco
Kent, Melanie
Henrar, Roland
Hickey, Joe
Shawcross, Debbie L
Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II)
title Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II)
title_full Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II)
title_fullStr Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II)
title_full_unstemmed Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II)
title_short Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II)
title_sort real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (impress ii)
topic Liver
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10086718/
https://www.ncbi.nlm.nih.gov/pubmed/37056320
http://dx.doi.org/10.1136/flgastro-2022-102221
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