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Rifaximin And hepatic encephalopathy

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https://www.readbyqxmd.com/read/27721918/implication-of-the-intestinal-microbiome-in-complications-of-cirrhosis
#1
Mamatha Bhat, Bianca M Arendt, Venkat Bhat, Eberhard L Renner, Atul Humar, Johane P Allard
The intestinal microbiome (IM) is altered in patients with cirrhosis, and emerging literature suggests that this impacts on the development of complications. The PubMed database was searched from January 2000 to May 2015 for studies and review articles on the composition, pathophysiologic effects and therapeutic modulation of the IM in cirrhosis. The following combination of relevant text words and MeSH terms were used, namely intestinal microbiome, microbiota, or dysbiosis, and cirrhosis, encephalopathy, spontaneous bacterial peritonitis, hepatorenal syndrome, variceal bleeding, hepatopulmonary syndrome, portopulmonary hypertension and hepatocellular carcinoma...
September 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27711069/rifaximin-microbiota-biology-and-hepatic-encephalopathy
#2
Cedric Peleman, Michael Camilleri
Rifaximin is beneficial in the treatment of minimal hepatic encephalopathy (MHE). Kang et al. (Clin Transl Gastroenterol 7: e187; doi:10.1038/ctg.2016.44) investigated the effects of rifaximin in a mouse model of MHE-associated microbiota without concomitant liver disease. In addition to some impact on the composition of microbiota, rifaximin altered bacterial functions, ameliorated local and systemic inflammation, and reduced enterocyte glutaminase activity. We discuss these effects as well as the interpretation of the permeability studies, given the potential interaction of dysbiosis with dysfunctional intestinal barrier, leading to systemic inflammation and increased uptake of bacterial metabolites that contribute to MHE in the presence of hepatic dysfunction...
October 6, 2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27645714/comment-on-treatment-of-acute-hepatic-encephalopathy-comparing-the-effects-of-adding-rifaximin-to-lactulose-on-patient-outcomes
#3
Sarah E Petite
No abstract text is available yet for this article.
September 19, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27571468/-hepatic-encephalopathy
#4
Davide Festi, Giovanni Marasco, Federico Ravaioli, Antonio Colecchia
Hepatic encephalopathy (HE) is a common complication of liver cirrhosis and it can manifest with a broad spectrum of neuropsychiatric abnormalities of varying severity, acuity and time course with important clinical implications. According to recent guidelines, HE has been classified into different types, depending on the severity of hepatic dysfunction, the presence of porto-systemic shunts and the number of previous episodes or persistent manifestations. From a clinical point of view, HE can be recognized as unimpaired, covert (that deals with minimal and grade 1 according to the grading of mental state), and overt (that is categorized from grade 2 to grade 4)...
July 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/27560928/rifaximin-exerts-beneficial-effects-independent-of-its-ability-to-alter-microbiota-composition
#5
Dae J Kang, Genta Kakiyama, Naga S Betrapally, Jeremy Herzog, Hiroshi Nittono, Phillip B Hylemon, Huiping Zhou, Ian Carroll, Jing Yang, Patrick M Gillevet, Chunhua Jiao, Hajime Takei, William M Pandak, Takashi Iida, Douglas M Heuman, Sili Fan, Oliver Fiehn, Takao Kurosawa, Masoumeh Sikaroodi, R B Sartor, Jasmohan S Bajaj
OBJECTIVES: Rifaximin has clinical benefits in minimal hepatic encephalopathy (MHE) but the mechanism of action is unclear. The antibiotic-dependent and -independent effects of rifaximin need to be elucidated in the setting of MHE-associated microbiota. To assess the action of rifaximin on intestinal barrier, inflammatory milieu and ammonia generation independent of microbiota using rifaximin. METHODS: Four germ-free (GF) mice groups were used (1) GF, (2) GF+rifaximin, (3) Humanized with stools from an MHE patient, and (4) Humanized+rifaximin...
2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27547007/use-of-rifaximin-in-gastrointestinal-and-liver-diseases
#6
REVIEW
Rani H Shayto, Rachel Abou Mrad, Ala I Sharara
Rifaximin is a broad spectrum oral antibiotic with antimicrobial activity against Gram-positive and Gram-negative aerobic and anaerobic bacteria. It is poorly absorbed and thus has a highly favorable safety profile. Rifaximin has been shown to be effective in the treatment of traveler's diarrhea, functional bloating and irritable bowel syndrome, small bowel bacterial overgrowth and in the prevention of recurrent overt hepatic encephalopathy. In addition, there is emerging evidence for a possible beneficial effect of rifaximin in the treatment of uncomplicated diverticular disease and in the prevention of recurrent diverticulitis...
August 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27507251/rifaximin-for-the-prevention-of-readmissions-for-patients-with-hepatic-encephalopathy-the-price-is-right
#7
EDITORIAL
Elliot B Tapper
No abstract text is available yet for this article.
September 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27457247/epilepsy-as-a-risk-factor-for-hepatic-encephalopathy-in-patients-with-cirrhosis-a-cohort-study
#8
Peter Jepsen, Jakob Christensen, Karin Weissenborn, Hugh Watson, Hendrik Vilstrup
BACKGROUND: Epilepsy is associated with an increased mortality among cirrhosis patients, but the reasons are unknown. We aimed to determine whether epilepsy is a risk factor for developing hepatic encephalopathy (HE), which is a strong predictor of mortality. METHODS: We used data from three randomized 1-year trials of satavaptan in cirrhosis patients with ascites. With Cox regression, we compared the hazard rates of HE grade 1-4 between those cirrhosis patients who did or did not have epilepsy...
2016: BMC Gastroenterology
https://www.readbyqxmd.com/read/27455934/characterization-of-polymorphic-forms-of-rifaximin
#9
Ana Carolina Kogawa, Selma Gutierrez Antonio, Hérida Regina Nunes Salgado
Rifaximin is a gut-selective oral antimicrobial that has no systemic adverse effects compared with placebo. It is used for the treatment of hepatic encephalopathy, traveler's diarrhea, irritable bowel syndrome, Clostridium difficile infection, ulcerative colitis, and acute diarrhea. The crystalline form present in rifaximin, α, has minimal systemic absorption compared to the amorphous form. The objective of this study was to obtain polymorphic forms of rifaximin using recrystallization processes. The forms were characterized and studied by thermal analysis, X-ray powder diffraction, scanning electron microscopy, and solubility testing...
July 2016: Journal of AOAC International
https://www.readbyqxmd.com/read/27366216/cost-effectiveness-analysis-of-rifaximin-%C3%AE-administration-for-the-reduction-of-episodes-of-overt-hepatic-encephalopathy-in-recurrence-compared-with-standard-treatment-in-france
#10
Anastasiia Kabeshova, Soumaia Ben Hariz, Elyonore Tsakeu, Robert Benamouzig, Robert Launois
BACKGROUND: Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome that occurs most often in a context of acute or chronic liver disease. Despite the seriousness of the pathology, only a few treatments have been developed for improving its management. Rifaximin-α is the first treatment that has been clinically developed for overt HE (OHE) episodes. Recent results of clinical studies demonstrated its significant improvement in the health-related quality of life. The objective of the current study was to estimate the long-term cost-effectiveness of rifaximin-α used in combination with lactulose compared with lactulose monotherapy in cirrhotic patients, who have experienced at least two prior OHE events...
July 2016: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/27285830/the-effect-of-sub-inhibitory-concentrations-of-rifaximin-on-urease-production-and-on-other-virulence-factors-expressed-by-klebsiella-pneumoniae-proteus-mirabilis-pseudomonas-aeruginosa-and-staphylococcus-aureus
#11
Annalisa Ricci, Erika Coppo, Ramona Barbieri, Eugenio A Debbia, Anna Marchese
Rifaximin, a topical derivative of rifampin, inhibited urease production and other virulence factors at sub-MIC concentrations in strains involved in hepatic encephalopathy and the expression of methicillin resistance in Staphylococcus aureus. In particular, urease production was affected in all Proteus mirabilis and Klebsiella pneumoniae strains as well as in all tested Pseudomonas aeruginosa isolates. Other exotoxins, synthesized by P. aeruginosa, such as protease, gelatinase, lipase, lecithinase and DNAse were also not metabolized in the presence of rifaximin...
June 10, 2016: Journal of Chemotherapy
https://www.readbyqxmd.com/read/27270559/rifamycins-alone-and-in-combination
#12
REVIEW
David M Rothstein
Rifamycins inhibit RNA polymerase of most bacterial genera. Rifampicin remains part of combination therapy for treating tuberculosis (TB), and for treating Gram-positive prosthetic joint and valve infections, in which biofilms are prominent. Rifabutin has use for AIDS patients in treating mycobacterial infections TB and Mycobacterium avium complex (MAC), having fewer drug-drug interactions that interfere with AIDS medications. Rifabutin is occasionally used in combination to eradicate Helicobacter pylori (peptic ulcer disease)...
2016: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/27246107/evidence-based-clinical-practice-guidelines-for-liver-cirrhosis-2015
#13
REVIEW
Hiroshi Fukui, Hidetsugu Saito, Yoshiyuki Ueno, Hirofumi Uto, Katsutoshi Obara, Isao Sakaida, Akitaka Shibuya, Masataka Seike, Sumiko Nagoshi, Makoto Segawa, Hirohito Tsubouchi, Hisataka Moriwaki, Akinobu Kato, Etsuko Hashimoto, Kojiro Michitaka, Toshikazu Murawaki, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for liver cirrhosis in 2015. Eighty-three clinical questions were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. Manual searching of the latest important literature was added until August 2015. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
July 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/27182210/contemporary-understanding-and-management-of-overt-and-covert-hepatic-encephalopathy
#14
Meghan NeSmith, Joseph Ahn, Steven L Flamm
Hepatic encephalopathy (HE) is a major complication of liver disease that leads to significant morbidity and mortality. Caring for hospitalized patients with HE is becoming more complex, and the economic burden of HE continues to rise. Defining and diagnosing HE, particularly covert HE (CHE), remain challenging. In this article, we review new tools and those currently under development for the diagnosis of CHE and the latest advances in the acute and long-term management of overt HE (OHE) and CHE. In particular, we review the latest data on the use of lactulose and rifaximin for treatment of OHE and summarize the data on adjunctive agents such as sodium benzoate and probiotics...
February 2016: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27153746/minimal-hepatic-encephalopathy-a-review
#15
REVIEW
Raffaele Nardone, Alexandra C Taylor, Yvonne Höller, Francesco Brigo, Piergiorgio Lochner, Eugen Trinka
Minimal hepatic encephalopathy (MHE) is the earliest form of hepatic encephalopathy and can affect up to 80% of patients with liver cirrhosis. By definition, MHE is characterized by cognitive function impairment in the domains of attention, vigilance and integrative function, but obvious clinical manifestation are lacking. MHE has been shown to affect daily functioning, quality of life, driving and overall mortality. The diagnosis can be achieved through neuropsychological testing, recently developed computerized psychometric tests, such as the critical flicker frequency and the inhibitory control tests, as well as neurophysiological procedures...
October 2016: Neuroscience Research
https://www.readbyqxmd.com/read/27136714/natural-history-of-patients-taking-rifaximin-%C3%AE-for-recurrent-hepatic-encephalopathy-and-risk-of-future-overt-episodes-and-mortality-a-post-hoc-analysis-of-clinical-trials-data
#16
Christian A Bannister, James G Orr, Alan V Reynolds, Mark Hudson, Peter Conway, Amr Radwan, Christopher Ll Morgan, Craig J Currie
PURPOSE: Hepatic encephalopathy (HE) is a complication of cirrhosis signaling decompensation and is associated with mortality. There has been little characterization of HE once an incident episode has occurred and of what effect the transition to overt HE might have on outcomes. We characterized the relationships between the number of previous HE episodes and risk of subsequent episodes and mortality to better understand the natural history of HE. METHODS: Data on 321 patients from a 24-month, open-label, nonrandomized trial evaluating the long-term safety profile and tolerability of twice-daily rifaximin-α 550 mg were analyzed...
May 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27126547/management-of-hepatic-encephalopathy-a-primer
#17
REVIEW
Tara Jawaro, Anna Yang, Deepali Dixit, Mary Barna Bridgeman
OBJECTIVE: To review the management of hepatic encephalopathy (HE), including lifestyle modifying strategies and pharmacological interventions. DATA SOURCES: A literature search of PubMed through March 2016 was conducted utilizing the keywords hepatic encephalopathy, ammonia, and cirrhosis All published articles evaluating treatments for HE were considered. STUDY SELECTION AND DATA EXTRACTION: Available English-language data from reviews, abstracts, presentations, and clinical trials of the treatment of HE in humans were reviewed; relevant clinical data were selected and included...
July 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27060899/hepatic-encephalopathy-in-dogs-and-cats
#18
Jonathan A Lidbury, Audrey K Cook, Jörg M Steiner
OBJECTIVE: To comparatively review the pathogenesis, clinical presentation, diagnosis, and management of hepatic encephalopathy (HE) in dogs and cats. DATA SOURCES: The Medline database was searched for articles related to HE in people, dogs, and cats. Articles published within the last 5 years were given special importance. HUMAN DATA SYNTHESIS: The pathogenesis of HE is complex and incompletely understood, but ammonia appears to play a central role...
July 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/26980242/development-of-an-experimental-rat-model-of-hyperammonemic-encephalopathy-and-evaluation-of-the-effects-of-rifaximin
#19
Satoru Tamaoki, Hiroyuki Suzuki, Mami Okada, Norio Fukui, Mitsui Isobe, Tomoyuki Saito
Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with hepatic dysfunction. However, the precise mechanism of HE is unclear. To elucidate the mechanism, we developed a new rat model of HE with coma using a combination of subcutaneous splenic transposition, partial hepatectomy and portal vein stenosis. In this model, blood ammonia levels increase in the postcaval vein over time and markedly increase in the cerebrospinal fluid (CSF). The distribution of ammonia in the various blood vessels in the HE model suggests that the origin of peripheral blood and CSF ammonia is the mesenteric veins that drain blood from the gastrointestinal tract...
May 15, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/26950766/the-impact-on-hospital-resource-utilisation-of-treatment-of-hepatic-encephalopathy-with-rifaximin-%C3%AE
#20
James G Orr, Craig J Currie, Ellen Berni, Anurag Goel, Kieran J Moriarty, Ashish Sinha, Fiona Gordon, Anne Dethier, John F Dillon, Katie Clark, Paul Richardson, Paul Middleton, Vishal Patel, Debbie Shawcross, Helen Preedy, Richard J Aspinall, Mark Hudson
BACKGROUND & AIMS: Rifaximin-α reduces the risk of recurrence of overt hepatic encephalopathy. However, there remain concerns regarding the financial cost of the drug. We aimed to study the impact of treatment with rifaximin-α on healthcare resource utilisation using data from seven UK liver treatment centres. METHODS: All seven centres agreed a standardised data set and data characterising clinical, demographic and emergency hospital admissions were collected retrospectively for the time periods 3, 6 and 12 months before and following initiation of rifaximin-α...
September 2016: Liver International: Official Journal of the International Association for the Study of the Liver
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