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Durability of Rifaximin Response in Hepatic Encephalopathy.
MedLine Citation:
PMID:  22011586     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Guy W Neff; Michael Jones; Taylor Broda; Mark Jonas; Ravinuthala Ravi; David Novick; Tiffany E Kaiser; Nyingi Kemmer
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-18
Journal Detail:
Title:  Journal of clinical gastroenterology     Volume:  -     ISSN:  1539-2031     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7910017     Medline TA:  J Clin Gastroenterol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Tampa General Medical Group, Tampa, FL †Tri-State Gastroenterology Associates ‡University of Indianapolis, Indianapolis, IN §Greater Cincinnati Gastroenterology Associates, Cincinnati ∥Digestive Specialists, Inc, Dayton, OH.
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