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Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy

BACKGROUND AND AIMS: Rifaximin is effective in preventing and treating hepatic encephalopathy (HE). This study aimed to investigate the efficacy and safety of different dosages of rifaximin in the treatment of cirrhotic patients with covert HE (CHE). METHODS: In this single-center, randomized, contr...

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Autores principales: Tan, Wei, Wang, Jian, Shi, Pei-Mei, Feng, Ling-Mei, Shi, Jian, Ning, Bei-Fang, Yuan, Zong-Li, Zeng, Xin, Xie, Wei-Fen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: XIA & HE Publishing Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634763/
https://www.ncbi.nlm.nih.gov/pubmed/36381088
http://dx.doi.org/10.14218/JCTH.2021.00457
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author Tan, Wei
Wang, Jian
Shi, Pei-Mei
Feng, Ling-Mei
Shi, Jian
Ning, Bei-Fang
Yuan, Zong-Li
Zeng, Xin
Xie, Wei-Fen
author_facet Tan, Wei
Wang, Jian
Shi, Pei-Mei
Feng, Ling-Mei
Shi, Jian
Ning, Bei-Fang
Yuan, Zong-Li
Zeng, Xin
Xie, Wei-Fen
author_sort Tan, Wei
collection PubMed
description BACKGROUND AND AIMS: Rifaximin is effective in preventing and treating hepatic encephalopathy (HE). This study aimed to investigate the efficacy and safety of different dosages of rifaximin in the treatment of cirrhotic patients with covert HE (CHE). METHODS: In this single-center, randomized, controlled, open-label study, CHE was diagnosed using a combination of the psychometric HE score and the EncephalApp Stroop test. Cirrhotic patients with CHE were recruited and randomly assigned to low-dose rifaximin 800 mg/day, high-dose rifaximin (1,200 mg/day), and control groups, and were treated for 8 weeks. The sickness impact profile (SIP) scale was used to evaluate the health-related quality of life (HRQOL) of patients. Forty patients were included in the study, 12 were assigned to the low-dose group, 14 to the high-dose group, and 14 patients to the control group. RESULTS: The percentage of patients with CHE reversal was significantly higher in both the low-dose (41.67%, 5/12) and high-dose (57.14%, 8/14) groups than in the control group (7.14%, 1/14) at 8 weeks (p=0.037 and p=0.005, respectively). In addition, both doses of rifaximin resulted in significant improvement of the total SIP score compared with the control group. There were no significant differences in the CHE reversal rate, total SIP score improvement, and incidence of adverse event between the low-dose and high-dose groups (p>0.05). CONCLUSIONS: Low-dose rifaximin reverses CHE and improves HRQOL in cirrhotic patients with comparable effects and safety to high-dose rifaximin.
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spelling pubmed-96347632022-11-14 Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy Tan, Wei Wang, Jian Shi, Pei-Mei Feng, Ling-Mei Shi, Jian Ning, Bei-Fang Yuan, Zong-Li Zeng, Xin Xie, Wei-Fen J Clin Transl Hepatol Original Article BACKGROUND AND AIMS: Rifaximin is effective in preventing and treating hepatic encephalopathy (HE). This study aimed to investigate the efficacy and safety of different dosages of rifaximin in the treatment of cirrhotic patients with covert HE (CHE). METHODS: In this single-center, randomized, controlled, open-label study, CHE was diagnosed using a combination of the psychometric HE score and the EncephalApp Stroop test. Cirrhotic patients with CHE were recruited and randomly assigned to low-dose rifaximin 800 mg/day, high-dose rifaximin (1,200 mg/day), and control groups, and were treated for 8 weeks. The sickness impact profile (SIP) scale was used to evaluate the health-related quality of life (HRQOL) of patients. Forty patients were included in the study, 12 were assigned to the low-dose group, 14 to the high-dose group, and 14 patients to the control group. RESULTS: The percentage of patients with CHE reversal was significantly higher in both the low-dose (41.67%, 5/12) and high-dose (57.14%, 8/14) groups than in the control group (7.14%, 1/14) at 8 weeks (p=0.037 and p=0.005, respectively). In addition, both doses of rifaximin resulted in significant improvement of the total SIP score compared with the control group. There were no significant differences in the CHE reversal rate, total SIP score improvement, and incidence of adverse event between the low-dose and high-dose groups (p>0.05). CONCLUSIONS: Low-dose rifaximin reverses CHE and improves HRQOL in cirrhotic patients with comparable effects and safety to high-dose rifaximin. XIA & HE Publishing Inc. 2022-12-28 2022-02-14 /pmc/articles/PMC9634763/ /pubmed/36381088 http://dx.doi.org/10.14218/JCTH.2021.00457 Text en © 2022 Authors. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0), permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Tan, Wei
Wang, Jian
Shi, Pei-Mei
Feng, Ling-Mei
Shi, Jian
Ning, Bei-Fang
Yuan, Zong-Li
Zeng, Xin
Xie, Wei-Fen
Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy
title Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy
title_full Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy
title_fullStr Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy
title_full_unstemmed Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy
title_short Effects of Low-dose and High-dose Rifaximin in the Treatment of Covert Hepatic Encephalopathy
title_sort effects of low-dose and high-dose rifaximin in the treatment of covert hepatic encephalopathy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634763/
https://www.ncbi.nlm.nih.gov/pubmed/36381088
http://dx.doi.org/10.14218/JCTH.2021.00457
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