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

Background and AimsRifaximin 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). MethodsIn this single-center, randomized, controlle...

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Bibliographic Details
Published in:	Journal of clinical and translational hepatology Vol. 10; no. 6; pp. 1099 - 1106
Main Authors:	Tan, Wei, Wang, Jian, Shi, Pei-Mei, Feng, Ling-Mei, Shi, Jian, Ning, Bei-Fang, Yuan, Zong-Li, Zeng, Xin, Xie, Wei-Fen
Format:	Journal Article
Language:	English
Published:	XIA & HE Publishing Inc 14-02-2022
Subjects:	Original
Online Access:	Get full text
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Summary:	Background and AimsRifaximin 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). MethodsIn 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. ResultsThe 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). ConclusionsLow-dose rifaximin reverses CHE and improves HRQOL in cirrhotic patients with comparable effects and safety to high-dose rifaximin.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally to this work. Designed the research and drafted the manuscript (WT, JW, WFX), presided over the enrollment and exclusion of patients (WT, XZ), followed up with the patients and collected the data (WT, PMS, LMF), checked the data (PMS, ZLY), statistical analysis of the data (WT, JW), revised the manuscript (XZ) None to declare. The authors have no conflict of interests related to this publication.
ISSN:	2225-0719 2310-8819
DOI:	10.14218/JCTH.2021.00457