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Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients

Covert hepatic encephalopathy (CHE) impairs patient quality of life and occurs in approximately 30% of liver cirrhosis (LC) cases. Japanese clinical practice guidelines recommend rifaximin to treat overt HE (OHE). However, the usefulness of rifaximin against CHE is not thoroughly investigated in Jap...

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Autores principales: Nakai, Masato, Suda, Goki, Ogawa, Koji, Yoshida, Sonoe, Hosoda, Shunichi, Kubo, Akinori, Tokuchi, Yoshimasa, Kitagataya, Takashi, Yamada, Ren, Shigesawa, Taku, Ohara, Masatsugu, Sho, Takuya, Morikawa, Kenichi, Sakamoto, Naoya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249214/
https://www.ncbi.nlm.nih.gov/pubmed/35776720
http://dx.doi.org/10.1371/journal.pone.0270786
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author Nakai, Masato
Suda, Goki
Ogawa, Koji
Yoshida, Sonoe
Hosoda, Shunichi
Kubo, Akinori
Tokuchi, Yoshimasa
Kitagataya, Takashi
Yamada, Ren
Shigesawa, Taku
Ohara, Masatsugu
Sho, Takuya
Morikawa, Kenichi
Sakamoto, Naoya
author_facet Nakai, Masato
Suda, Goki
Ogawa, Koji
Yoshida, Sonoe
Hosoda, Shunichi
Kubo, Akinori
Tokuchi, Yoshimasa
Kitagataya, Takashi
Yamada, Ren
Shigesawa, Taku
Ohara, Masatsugu
Sho, Takuya
Morikawa, Kenichi
Sakamoto, Naoya
author_sort Nakai, Masato
collection PubMed
description Covert hepatic encephalopathy (CHE) impairs patient quality of life and occurs in approximately 30% of liver cirrhosis (LC) cases. Japanese clinical practice guidelines recommend rifaximin to treat overt HE (OHE). However, the usefulness of rifaximin against CHE is not thoroughly investigated in Japanese patients. We aimed to investigate the efficacy of rifaximin against hyperammonemia and CHE in Japan. We observed 102 patients with HE showing hyperammonemia secondary to LC and examined various biochemical and behavioral parameters following rifaximin treatment. CHE was diagnosed when the patients exhibited two or more abnormal neuropsychological test (NPT) scores but did not indicate OHE symptoms. In the 102 cases, a significant therapeutic effect of rifaximin on hyperammonemia was observed from 2 to 48 weeks after starting treatment. Excluding 10 patients diagnosed with OHE upon starting rifaximin treatment, 12 of the 92 remaining patients (11.8%) transitioned to OHE within 1 year. The 1 year cumulative OHE transition rate was 14.5%. Among the 24 patients with CHE diagnosed by the NPT for whom NPT results could be evaluated at 4 and 12 weeks after starting treatment, 10 (41.6%) had recovered from CHE at 12 weeks. When the factors contributing to recovery from CHE were examined by multivariate analysis, an ammonia level <129 μg/dL was a significant factor. Rifaximin was thus significantly effective against both hyperammonemia and CHE in Japanese patients.
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spelling pubmed-92492142022-07-02 Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients Nakai, Masato Suda, Goki Ogawa, Koji Yoshida, Sonoe Hosoda, Shunichi Kubo, Akinori Tokuchi, Yoshimasa Kitagataya, Takashi Yamada, Ren Shigesawa, Taku Ohara, Masatsugu Sho, Takuya Morikawa, Kenichi Sakamoto, Naoya PLoS One Research Article Covert hepatic encephalopathy (CHE) impairs patient quality of life and occurs in approximately 30% of liver cirrhosis (LC) cases. Japanese clinical practice guidelines recommend rifaximin to treat overt HE (OHE). However, the usefulness of rifaximin against CHE is not thoroughly investigated in Japanese patients. We aimed to investigate the efficacy of rifaximin against hyperammonemia and CHE in Japan. We observed 102 patients with HE showing hyperammonemia secondary to LC and examined various biochemical and behavioral parameters following rifaximin treatment. CHE was diagnosed when the patients exhibited two or more abnormal neuropsychological test (NPT) scores but did not indicate OHE symptoms. In the 102 cases, a significant therapeutic effect of rifaximin on hyperammonemia was observed from 2 to 48 weeks after starting treatment. Excluding 10 patients diagnosed with OHE upon starting rifaximin treatment, 12 of the 92 remaining patients (11.8%) transitioned to OHE within 1 year. The 1 year cumulative OHE transition rate was 14.5%. Among the 24 patients with CHE diagnosed by the NPT for whom NPT results could be evaluated at 4 and 12 weeks after starting treatment, 10 (41.6%) had recovered from CHE at 12 weeks. When the factors contributing to recovery from CHE were examined by multivariate analysis, an ammonia level <129 μg/dL was a significant factor. Rifaximin was thus significantly effective against both hyperammonemia and CHE in Japanese patients. Public Library of Science 2022-07-01 /pmc/articles/PMC9249214/ /pubmed/35776720 http://dx.doi.org/10.1371/journal.pone.0270786 Text en © 2022 Nakai et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nakai, Masato
Suda, Goki
Ogawa, Koji
Yoshida, Sonoe
Hosoda, Shunichi
Kubo, Akinori
Tokuchi, Yoshimasa
Kitagataya, Takashi
Yamada, Ren
Shigesawa, Taku
Ohara, Masatsugu
Sho, Takuya
Morikawa, Kenichi
Sakamoto, Naoya
Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients
title Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients
title_full Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients
title_fullStr Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients
title_full_unstemmed Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients
title_short Efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in Japanese patients
title_sort efficacy of rifaximin against covert hepatic encephalopathy and hyperammonemia in japanese patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249214/
https://www.ncbi.nlm.nih.gov/pubmed/35776720
http://dx.doi.org/10.1371/journal.pone.0270786
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