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Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites

Background and Objectives: To investigate the long-term efficacy of rifaximin (RFX) for hyperammonemia and efficacy for refractory ascites in patients with cirrhosis. Materials and Methods: We enrolled 112 patients with liver cirrhosis who were orally administered RFX in this study. Changes in the c...

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Autores principales: Yokoyama, Keiji, Fukuda, Hiromi, Yamauchi, Ryo, Higashi, Masashi, Miyayama, Takashi, Higashi, Tomotaka, Uchida, Yotaro, Shibata, Kumiko, Tsuchiya, Naoaki, Fukunaga, Atsushi, Umeda, Kaoru, Takata, Kazuhide, Tanaka, Takashi, Shakado, Satoshi, Sakisaka, Shotaro, Hirai, Fumihito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501622/
https://www.ncbi.nlm.nih.gov/pubmed/36143954
http://dx.doi.org/10.3390/medicina58091276
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author Yokoyama, Keiji
Fukuda, Hiromi
Yamauchi, Ryo
Higashi, Masashi
Miyayama, Takashi
Higashi, Tomotaka
Uchida, Yotaro
Shibata, Kumiko
Tsuchiya, Naoaki
Fukunaga, Atsushi
Umeda, Kaoru
Takata, Kazuhide
Tanaka, Takashi
Shakado, Satoshi
Sakisaka, Shotaro
Hirai, Fumihito
author_facet Yokoyama, Keiji
Fukuda, Hiromi
Yamauchi, Ryo
Higashi, Masashi
Miyayama, Takashi
Higashi, Tomotaka
Uchida, Yotaro
Shibata, Kumiko
Tsuchiya, Naoaki
Fukunaga, Atsushi
Umeda, Kaoru
Takata, Kazuhide
Tanaka, Takashi
Shakado, Satoshi
Sakisaka, Shotaro
Hirai, Fumihito
author_sort Yokoyama, Keiji
collection PubMed
description Background and Objectives: To investigate the long-term efficacy of rifaximin (RFX) for hyperammonemia and efficacy for refractory ascites in patients with cirrhosis. Materials and Methods: We enrolled 112 patients with liver cirrhosis who were orally administered RFX in this study. Changes in the clinical data of patients were evaluated up to 36 months after RFX administration. The primary endpoint was a change in blood ammonia levels. Secondary endpoints included changes in clinical symptoms, Child–Pugh (CP) score, number of hospitalizations, degree of refractory ascites, adverse events, and the relationship between RFX administration and the renin-angiotensin-aldosterone system. Results: An improved rate of overt hepatic encephalopathy (HE) of 82.7% was observed 3 months after RFX administration, which significantly induced a progressive decrease in blood ammonia concentration and an improved CP score up to 36 months. No serious RFX treatment-related adverse events were observed. 36.5% in patients after RFX administration improved refractory ascites. After RFX administration, patients with satisfactory control of hepatic ascites without addition of diuretic had lower renin concentration than those with poor control (p < 0.01). At less than 41 pg/mL renin concentration, the control of refractory ascites was significantly satisfactory (p < 0.0001). Conclusions: RFX reduced blood ammonia concentration and improved hepatic spare ability and the quality of life of patients with long-term HE to up to 36 months. Our study revealed the effects of RFX against refractory ascites, suggesting that renin concentration may be a predictive marker for assessing ascites control.
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spelling pubmed-95016222022-09-24 Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites Yokoyama, Keiji Fukuda, Hiromi Yamauchi, Ryo Higashi, Masashi Miyayama, Takashi Higashi, Tomotaka Uchida, Yotaro Shibata, Kumiko Tsuchiya, Naoaki Fukunaga, Atsushi Umeda, Kaoru Takata, Kazuhide Tanaka, Takashi Shakado, Satoshi Sakisaka, Shotaro Hirai, Fumihito Medicina (Kaunas) Article Background and Objectives: To investigate the long-term efficacy of rifaximin (RFX) for hyperammonemia and efficacy for refractory ascites in patients with cirrhosis. Materials and Methods: We enrolled 112 patients with liver cirrhosis who were orally administered RFX in this study. Changes in the clinical data of patients were evaluated up to 36 months after RFX administration. The primary endpoint was a change in blood ammonia levels. Secondary endpoints included changes in clinical symptoms, Child–Pugh (CP) score, number of hospitalizations, degree of refractory ascites, adverse events, and the relationship between RFX administration and the renin-angiotensin-aldosterone system. Results: An improved rate of overt hepatic encephalopathy (HE) of 82.7% was observed 3 months after RFX administration, which significantly induced a progressive decrease in blood ammonia concentration and an improved CP score up to 36 months. No serious RFX treatment-related adverse events were observed. 36.5% in patients after RFX administration improved refractory ascites. After RFX administration, patients with satisfactory control of hepatic ascites without addition of diuretic had lower renin concentration than those with poor control (p < 0.01). At less than 41 pg/mL renin concentration, the control of refractory ascites was significantly satisfactory (p < 0.0001). Conclusions: RFX reduced blood ammonia concentration and improved hepatic spare ability and the quality of life of patients with long-term HE to up to 36 months. Our study revealed the effects of RFX against refractory ascites, suggesting that renin concentration may be a predictive marker for assessing ascites control. MDPI 2022-09-14 /pmc/articles/PMC9501622/ /pubmed/36143954 http://dx.doi.org/10.3390/medicina58091276 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yokoyama, Keiji
Fukuda, Hiromi
Yamauchi, Ryo
Higashi, Masashi
Miyayama, Takashi
Higashi, Tomotaka
Uchida, Yotaro
Shibata, Kumiko
Tsuchiya, Naoaki
Fukunaga, Atsushi
Umeda, Kaoru
Takata, Kazuhide
Tanaka, Takashi
Shakado, Satoshi
Sakisaka, Shotaro
Hirai, Fumihito
Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites
title Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites
title_full Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites
title_fullStr Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites
title_full_unstemmed Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites
title_short Long-Term Effects of Rifaximin on Patients with Hepatic Encephalopathy: Its Possible Effects on the Improvement in the Blood Ammonia Concentration Levels, Hepatic Spare Ability and Refractory Ascites
title_sort long-term effects of rifaximin on patients with hepatic encephalopathy: its possible effects on the improvement in the blood ammonia concentration levels, hepatic spare ability and refractory ascites
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501622/
https://www.ncbi.nlm.nih.gov/pubmed/36143954
http://dx.doi.org/10.3390/medicina58091276
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