Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis : A pilot study (RIFA-AH)
© 2022 The Authors. Liver International published by John Wiley & Sons Ltd..
BACKGROUND & AIMS: Alcoholic hepatitis (AH) is associated with a high incidence of infection and mortality. Rifaximin reduces bacterial overgrowth and translocation. We aimed to study whether the administration of rifaximin as an adjuvant treatment to corticosteroids decreases the number of bacterial infections at 90 days in patients with severe AH compared to a control cohort.
METHODS: This was a multicentre, open, comparative pilot study of the addition of rifaximin (1200 mg/day/90 days) to the standard treatment for severe AH. The results were compared with a carefully matched historical cohort of patients treated with standard therapy and matching by age and model of end-stage liver disease (MELD). We evaluated bacterial infections, liver-related complications, mortality and liver function tests after 90 days.
RESULTS: Twenty-one and 42 patients were included in the rifaximin and control groups respectively. No significant baseline differences were found between groups. The mean number of infections per patient was 0.29 and 0.62 in the rifaximin and control groups, respectively (p = .049), with a lower incidence of acute-on-chronic liver failure (ACLF) linked to infections within the treatment group. Liver-related complications were lower within the rifaximin group (0.43 vs. 1.26 complications/patient respectively) (p = .01). Mortality was lower in the treated versus the control groups (14.2% vs. 30.9, p = .15) without significant differences. No serious adverse events were associated with rifaximin treatment.
CONCLUSIONS: Rifaximin is safe in severe AH with a significant reduction in clinical complications. A lower number of infections and a trend towards a lower ACLF and mortality favours its use in these patients.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Liver international : official journal of the International Association for the Study of the Liver - 42(2022), 5 vom: 27. Mai, Seite 1109-1120 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jiménez, César [VerfasserIn] |
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| Links: |
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| Themen: |
Acute-on-chronic liver failure |
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| Anmerkungen: |
Date Completed 25.04.2022 Date Revised 01.05.2023 published: Print-Electronic CommentIn: Liver Int. 2022 Jul;42(7):1697. - PMID 35567756 Citation Status MEDLINE |
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| doi: |
10.1111/liv.15207 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM337521298 |
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| 245 | 1 | 0 | |a Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis |b A pilot study (RIFA-AH) |
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| 500 | |a Date Completed 25.04.2022 | ||
| 500 | |a Date Revised 01.05.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Liver Int. 2022 Jul;42(7):1697. - PMID 35567756 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 The Authors. Liver International published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND & AIMS: Alcoholic hepatitis (AH) is associated with a high incidence of infection and mortality. Rifaximin reduces bacterial overgrowth and translocation. We aimed to study whether the administration of rifaximin as an adjuvant treatment to corticosteroids decreases the number of bacterial infections at 90 days in patients with severe AH compared to a control cohort | ||
| 520 | |a METHODS: This was a multicentre, open, comparative pilot study of the addition of rifaximin (1200 mg/day/90 days) to the standard treatment for severe AH. The results were compared with a carefully matched historical cohort of patients treated with standard therapy and matching by age and model of end-stage liver disease (MELD). We evaluated bacterial infections, liver-related complications, mortality and liver function tests after 90 days | ||
| 520 | |a RESULTS: Twenty-one and 42 patients were included in the rifaximin and control groups respectively. No significant baseline differences were found between groups. The mean number of infections per patient was 0.29 and 0.62 in the rifaximin and control groups, respectively (p = .049), with a lower incidence of acute-on-chronic liver failure (ACLF) linked to infections within the treatment group. Liver-related complications were lower within the rifaximin group (0.43 vs. 1.26 complications/patient respectively) (p = .01). Mortality was lower in the treated versus the control groups (14.2% vs. 30.9, p = .15) without significant differences. No serious adverse events were associated with rifaximin treatment | ||
| 520 | |a CONCLUSIONS: Rifaximin is safe in severe AH with a significant reduction in clinical complications. A lower number of infections and a trend towards a lower ACLF and mortality favours its use in these patients | ||
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