Durability of rifaximin response in hepatic encephalopathy.
J Clin Gastroenterol
; 46(2): 168-71, 2012 Feb.
Article
em En
| MEDLINE
| ID: mdl-22011586
ABSTRACT
GOALS To evaluate the durability of the response to rifaximin for treatment of hepatic encephalopathy (HE). BACKGROUND:
The nonsystemic antibiotic rifaximin has been approved for maintenance of HE remission, and several studies have indicated the efficacy of rifaximin for acute HE; however, the duration of therapeutic response for >6 months remains unknown. STUDY Medical records of patients with cirrhosis who received rifaximin maintenance therapy for HE between January 2004 and May 2009 were reviewed. Model for end-stage liver disease (MELD) scores were obtained every 3 months during therapy.RESULTS:
Of 203 patients with HE (Conn score ≥2), 149 received rifaximin monotherapy (400 to 1600 mg/d) and 54 received rifaximin (600 to 1200 mg/d) and lactulose (90 mL/d) dual therapy. Maintenance of HE remission for 1 year occurred in 81% and 67% of patients who received rifaximin monotherapy and rifaximin and lactulose dual therapy, respectively. Patient populations with a baseline mean MELD score ≤20 had few overt HE events, suggesting increased response to rifaximin in these patients.CONCLUSIONS:
Rifaximin is effective for the management of HE in patients with cirrhosis, particularly in populations with MELD scores ≤20. Additional studies are needed to investigate the potential association between MELD scores and the efficacy of HE treatments.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Rifamicinas
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Fármacos Gastrointestinais
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Encefalopatia Hepática
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Doença Hepática Terminal
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Lactulose
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Cirrose Hepática
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Anti-Infecciosos
Tipo de estudo:
Prognostic_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Clin Gastroenterol
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos