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Rifaximin And hepatic encephalopathy

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https://www.readbyqxmd.com/read/29235218/efficacy-and-safety-of-rifaximin-in-japanese-patients-with-hepatic-encephalopathy-a-phase-2-3-multicenter-randomized-evaluator-blinded-active-controlled-trial-and-a-phase-3-multicenter-open-trial
#1
Kazuyuki Suzuki, Ryujin Endo, Yasuhiro Takikawa, Fuminori Moriyasu, Yutaka Aoyagi, Hisataka Moriwaki, Shuji Terai, Isao Sakaida, Yoshiyuki Sakai, Shuhei Nishiguchi, Toru Ishikawa, Hitoshi Takagi, Atsushi Naganuma, Takuya Genda, Takafumi Ichida, Koichi Takaguchi, Katsuhiko Miyazawa, Kiwamu Okita
AIM: The efficacy and safety of rifaximin in the treatment of hepatic encephalopathy (HE) are widely known, but they have not been confirmed in Japanese patients with HE. Thus, two prospective, randomized studies (phase 2/3 study and phase 3 study) were conducted. METHODS: Subjects with grade I or II HE and hyperammonemia were enrolled. The phase 2/3 study, which was a randomized, evaluator-blinded, active-comparator, parallel-group study, was conducted at 37 institutions in Japan...
December 13, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29201772/managing-encephalopathy-in-the-outpatient-setting
#2
REVIEW
Tarana Gupta, Sahaj Rathi, Radha K Dhiman
In cirrhosis of liver, hepatic encephalopathy (HE) has an important impact on health-related quality of life. It is important to define whether HE is episodic, recurrent, or persistent; types A, B, or C; overt HE or covert HE; and spontaneous or precipitated. The overt HE is clinically evident and needs hospitalization. Nonabsorbable disaccharides, rifaximin, and probiotics are proven to be useful in the treatment of overt HE. Covert HE includes both minimal HE and grade I HE. It is not apparent on routine clinical examination...
January 2017: Euroasian journal of hepato-gastroenterology
https://www.readbyqxmd.com/read/29201193/effect-of-different-treatments-and-alcohol-addiction-on-gut-microbiota-in-minimal-hepatic-encephalopathy-patients
#3
Zan Zuo, Hong Fan, Xiao-Dan Tang, Yan-Min Chen, Lin-Ting Xun, Yan Li, Zheng-Ji Song, Hui-Qiong Zhai
Minimal hepatic encephalopathy (MHE) is caused by dysbiosis of gut microbiota, particularly the ammonia-producing bacteria. Given the efficacy of certain treatments on MHE and the connection between alcoholism and MHE, a thorough understanding of how these strategies affect the gut microbiota in patients (alcoholic or non-alcoholic) will facilitate the assessment of their efficacy in the reshaping of gut microbiota. In the present study, a metagenomics approach was adopted to reveal alterations in gut microbiota of 14 MHE patients following treatment with rifaximin alone or rifaximin plus probiotics...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29171503/-prevention-and-treatment-of-hepatic-encephalopathy
#4
Yu P Sivolap
Hepatic encephalopathy is a common neuropsychiatric complication of serious liver diseases and serves as a marker for worsening of their course and increasing the risk of death. The principal pathogenesis factors of hepatic encephalopathy is the excessive formation of ammonia and its accumulation by astrocytes. A key role in the prevention and treatment of hepatic encephalopathy is played by drugs that prevent hyperammonemia and promote the removal of ammonia from the body, namely lactulose, rifaximin and L-ornithine-L-aspartate...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/29069372/breakthrough-clostridium-difficile-infection-in-cirrhotic-patients-receiving-rifaximin
#5
E Reigadas, L Alcalá, J Gómez, M Marín, A Martin, R Onori, P Muñoz, E Bouza
Background: Patients with cirrhosis are at high risk of Clostridium difficile infection (CDI). Rifaximin is commonly used in cirrhotic patients as prophylaxis for hepatic encephalopathy (HE). Several studies have demonstrated the efficacy of rifaximin in the treatment of CDI; however, resistance to rifaximin has also been reported. Few studies have assessed the risk of developing CDI in cirrhotic patients receiving rifaximin. Our objective was to assess the incidence and characteristics of CDI in cirrhotic patients, especially in those who received rifaximin...
October 23, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29067149/the-impact-of-rifaximin-%C3%AE-on-the-hospital-resource-use-associated-with-the-management-of-patients-with-hepatic-encephalopathy-a-retrospective-observational-study-impress
#6
Mark Hudson, Amr Radwan, Paola Di Maggio, Riccardo Cipelli, Stephen D Ryder, John F Dillon, William Jonathan Cash, Robert T Przemioslo, Mark Wright, Debbie L Shawcross, Rajiv Jalan, Sushma Saksena, Michael Allison, Paul Richardson, Elizabeth Farrington, Richard J Aspinall
OBJECTIVE: To compare all-cause and liver-related hospital resource use in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation in UK patients with hepatic encephalopathy (HE). DESIGN: A UK multicentre, retrospective, observational study. Patients' medical records were reviewed for demographics, clinical outcomes and adverse events (AEs) to rifaximin-α. Details of hospital admissions/attendances in the 6 and 12 months pre-rifaximin-α and post-rifaximin-α initiation were extracted from hospital electronic databases...
October 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/29026340/economic-impact-of-the-use-of-rifaximin-550-mg-twice-daily-for-the-treatment-of-overt-hepatic-encephalopathy-in-italy
#7
Daniela Paola Roggeri, Alessandro Roggeri
PURPOSE: Hepatic encephalopathy (HE) is associated with a reduced survival, an increased risk of hospitalization for recurrences, and a reduced health-related quality of life. The purpose of the present economic analysis was to evaluate the impact on the Italian National Health Service (INHS) expenditure of the treatment with rifaximin 550 mg twice daily (Tixteller(®)/Tixtar(®)) for the reduction of the recurrences of overt HE, with respect to the current treatment approach. PATIENTS AND METHODS: Costs associated with patients treated with rifaximin 550 mg twice daily were estimated considering the reduction in hospitalizations for HE recurrences revealed by registrative clinical trial (-50%) applied to the hospitalization rate (42...
2017: Hepatic Medicine: Evidence and Research
https://www.readbyqxmd.com/read/29020023/the-continuous-reaction-time-test-for-minimal-hepatic-encephalopathy-validated-by-a-randomized-controlled-multi-modal-intervention-a-pilot-study
#8
RANDOMIZED CONTROLLED TRIAL
M M Lauridsen, S Mikkelsen, T Svensson, J Holm, C Klüver, J Gram, H Vilstrup, O B Schaffalitzky de Muckadell
BACKGROUND: Minimal hepatic encephalopathy (MHE) is clinically undetectable and the diagnosis requires psychometric tests. However, a lack of clarity exists as to whether the tests are in fact able to detect changes in cognition. AIM: To examine if the continuous reaction time test (CRT) can detect changes in cognition with anti-HE intervention in patients with cirrhosis and without clinically manifest hepatic encephalopathy (HE). METHODS: Firstly, we conducted a reproducibility analysis and secondly measured change in CRT induced by anti-HE treatment in a randomized controlled pilot study: We stratified 44 patients with liver cirrhosis and without clinically manifest HE according to a normal (n = 22) or abnormal (n = 22) CRT...
2017: PloS One
https://www.readbyqxmd.com/read/28982166/emergence-of-rifampin-resistant-staphylococci-after-rifaximin-administration-in-cirrhotic-patients
#9
Ji Young Chang, Seong-Eun Kim, Tae Hun Kim, So-Youn Woo, Min Sun Ryu, Yang-Hee Joo, Ko Eun Lee, Jihyun Lee, Kang Hoon Lee, Chang Mo Moon, Hye-Kyung Jung, Ki-Nam Shim, Sung-Ae Jung
OBJECTIVES: Rifaximin, a poorly absorbed antibiotics, has gut-specific therapeutic effects. Although frequently prescribed to manipulate intestinal luminal bacterial population in various diseases, the possible induction of antibacterial cross-resistance to a target pathogen is a major concern in long-term rifaximin administration. We aimed to evaluate whether rifampin-resistant staphylococci could evolve after rifaximin treatment in cirrhotic patients. METHOD: A total of 25 cirrhotic patients who were administered rifaximin for the prevention of hepatic encephalopathy were enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28936406/gut-microbiome-based-therapeutics-in-liver-cirrhosis-basic-consideration-for-the-next-step
#10
REVIEW
Hiroshi Fukui
Infections account for significant morbidity and mortality in liver cirrhosis and most are related to the gut microbiome. Fecal dysbiosis, characterized by an overgrowth of potentially pathogenic bacteria and a decrease in autochthonous non-pathogenic bacteria, becomes prominent with the progression of liver cirrhosis. In cirrhotic patients, disruption of the intestinal barrier causes intestinal hyperpermeability (i.e. leaky gut), which is closely related to gut dysmotility, dysbiosis and small intestinal bacterial overgrowth and may induce pathological bacterial translocation...
September 28, 2017: Journal of Clinical and Translational Hepatology
https://www.readbyqxmd.com/read/28836723/rifaximin-treatment-is-associated-with-reduced-risk-of-cirrhotic-complications-and-prolonged-overall-survival-in-patients-experiencing-hepatic-encephalopathy
#11
S H Kang, Y B Lee, J-H Lee, J Y Nam, Y Chang, H Cho, J-J Yoo, Y Y Cho, E J Cho, S J Yu, M Y Kim, Y J Kim, S K Baik, J-H Yoon
BACKGROUND: Rifaximin might decrease the risk of portal hypertension-related complications by controlling small intestinal bacterial overgrowth. AIM: To evaluate whether rifaximin was associated with the risk of death and cirrhotic complications. METHODS: We conducted a retrospective study that included 1042 patients experiencing hepatic encephalopathy (HE): 421 patients without hepatocellular carcinoma (HCC; the non-HCC cohort) and 621 patients with HCC (the HCC cohort)...
November 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28799305/comparison-of-rifaximin-plus-lactulose-with-the-lactulose-alone-for-the-treatment-of-hepatic-encephalopathy
#12
Kiran Ahire, Archana Sonawale
INTRODUCTION: Hepatic encephalopathy is challenging complication of liver dysfunction. Therapeutic treatment options for hepatic encephalopathy are currently limited and have appreciable risks and benefits associated with their use. Rifaximin is a novel anti microbiological agent with wide spectrum of activity that has shown promise as an alternative option for hepatic encephalopathy. AIMS AND OBJECTIVE: The present study was undertaken to compare the effectiveness of Rifaximin and Lactulose as a combination vs Lactulose alone, to compare the adverse effects and to study the rapidity of therapeutic effects of Rifaximin and Lactulose...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28533911/hepatic-encephalopathy
#13
Peter Ferenci
Hepatic encephalopathy (HE) is a reversible syndrome of impaired brain function occurring in patients with advanced liver diseases. The precise pathophysiology of HE is still under discussion; the leading hypothesis focus on the role of neurotoxins, impaired neurotransmission due to metabolic changes in liver failure, changes in brain energy metabolism, systemic inflammatory response and alterations of the blood brain barrier. HE produces a wide spectrum of nonspecific neurological and psychiatric manifestations...
May 2017: Gastroenterology Report
https://www.readbyqxmd.com/read/28518283/branched-chain-amino-acids-for-people-with-hepatic-encephalopathy
#14
REVIEW
Lise Lotte Gluud, Gitte Dam, Iñigo Les, Giulio Marchesini, Mette Borre, Niels Kristian Aagaard, Hendrik Vilstrup
BACKGROUND: Hepatic encephalopathy is a brain dysfunction with neurological and psychiatric changes associated with liver insufficiency or portal-systemic shunting. The severity ranges from minor symptoms to coma. A Cochrane systematic review including 11 randomised clinical trials on branched-chain amino acids (BCAA) versus control interventions has evaluated if BCAA may benefit people with hepatic encephalopathy. OBJECTIVES: To evaluate the beneficial and harmful effects of BCAA versus any control intervention for people with hepatic encephalopathy...
May 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28501926/an-outbreak-of-clostridium-difficile-pcr-ribotype-027-in-spain-risk-factors-for-recurrence-and-a-novel-treatment-strategy
#15
E Bouza, L Alcalá, M Marín, M Valerio, E Reigadas, P Muñoz, M González-Del Vecchio, V de Egea
An outbreak of Clostridium difficile infection (CDI) caused by ribotype 027 (B1/NAP1) began in our hospital in November 2014, and produced 141 episodes in the following months. The aim of this study is to describe this outbreak, assess risk factors for recurrence of CDI-027 and to analyze the implementation of a novel treatment strategy. This is a prospective study of all patients with CDI-027, from November 2014 to November 2015. The epidemiological data were collected daily for each patient. We compared clinical characteristics and treatment between patients with and without recurrence of CDI-027...
October 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28500320/oral-administration-of-trace-element-magnesium-significantly-improving-the-cognition-and-locomotion-in-hepatic-encephalopathy-rats
#16
Ying Li, Chang Xue Ji, Li Hong Mei, Jin Wei Qiang, Shuai Ju
The therapeutic effects of iron, zinc and magnesium trace elements, as well as rifaximin were investigated and compared in HE rats. In this study, HE rats were treated with either ferrous sulfate (HE-Fe, 30 mg/kg/day), zinc sulfate (HE-Zn, 30 mg/kg/day), magnesium sulfate (HE-Mg, 50 mg/kg/day) or rifaximin (HE-Rf, 50 mg/kg/day), which was mixed with water and administered orally for 61 days. The Morris water maze (MWM) and open-field tests were used to evaluate cognitive and locomotor function. The blood ammonia levels before and after administration of the glutamine challenge test, manganese concentration and glutamine synthetase (GS) activity were measured...
May 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28491179/transhepatic-embolization-of-a-congenital-intrahepatic-portosystemic-shunt-for-the-treatment-of-hepatic-encephalopathy-in-a-noncirrhotic-patient-using-amplatzer-vascular-plug-device
#17
Rachel Ann Brader, Kyung Rae Kim
A 73-year-old male with no history of liver disease was hospitalized for weakness, confusion, ataxia, and new onset hepatic encephalopathy with hyperammonemia. After management with lactulose and rifaximin, his symptoms persisted, and he underwent transjugular liver biopsy. Biopsy showed normal liver, but a portosystemic shunt was incidentally identified on postbiopsy venogram. The patient underwent occlusion of the shunt with two Amplatzer vascular plugs and four Nester coils. Following embolization, the patient's symptoms resolved completely...
June 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/28471831/response-to-improvement-of-sleep-architecture-parameters-in-cirrhotic-patients-with-recurrent-hepatic-encephalopathy-with-the-use-of-rifaximin-hepatic-encephalopathy-in-association-with-zolpidem
#18
LETTER
Ofir N Nevo, Allen D Brinker, Ida-Lina Diak, Cindy M Kortepeter
No abstract text is available yet for this article.
September 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28392702/hepatic-encephalopathy-what-the-multidisciplinary-team-can-do
#19
REVIEW
Andy Liu, Eric R Yoo, Osama Siddique, Ryan B Perumpail, George Cholankeril, Aijaz Ahmed
Hepatic encephalopathy (HE) is a complex disease requiring a multidisciplinary approach among specialists, primary care team, family, and caregivers. HE is currently a diagnosis of exclusion, requiring an extensive workup to exclude other possible etiologies, including mental status changes, metabolic, infectious, traumatic, and iatrogenic causes. The categorization of HE encompasses a continuum, varying from the clinically silent minimal HE (MHE), which is only detectable using psychometric tests, to overt HE, which is further divided into four grades of severity...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28177545/retrospective-cross-sectional-pilot-study-of-rifaximin-dosing-for-the-prevention-of-recurrent-hepatic-encephalopathy
#20
REVIEW
Kelsey C Lyon, Eric Likar, Jay L Martello, Michael Regier
Standard treatment for hepatic encephalopathy (HE) includes medications that reduce ammonia and bacterial translocation in the gut. Rifaximin can be used off-label for the reduction of overt HE. The study purpose was to determine efficacy of traditional rifaximin dosing (400 mg three times daily) compared to newer dosing (550 mg twice daily) via readmission rates for the prevention of recurrent HE. This was a retrospective, observational, cross-sectional pilot study conducted in a tertiary medical center...
February 8, 2017: Journal of Gastroenterology and Hepatology
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