Cyclic treatment of chronic hepatic encephalopathy with rifaximin. Results of a double-blind clinical study.

Abstract

BACKGROUND:

Chronic hepatic encephalopathy (HE) represents a frequent and serious complication of chronic liver disease. Aim of the study is to comparatively evaluate the effect of rifaximin, lactitol and their combination in treating chronic HE.

METHODS:

Forty out-patients (29 males, 11 females, mean age: 59 years, range 40-70), with viral liver cirrhosis and chronic HE (1st-2nd degree) were studied. HE was assessed by considering: mental state, asterixis, number connection test (NCT), arterial blood ammonia levels. Patients were randomly assigned to the following treatments: rifaximin (plus sorbitol as placebo) (group R); lactitol (group L); rifaximin plus lactitol (group RL). All treatments were continued for 15 days for 3 cycles, intervalled by 15 days of washout.

RESULTS:

The 3 treatments reduced HE, but with different efficacy: patients of group R and RL significantly (p<0.05) documented a faster improvement in HE degree, a higher percentage of patients which normalized mental state and NCT, a faster improvement of asterixis and a longer persistence of normal ammonia levels than patients of group L.

CONCLUSIONS:

Rifaximin in combination with lactitol or sorbitol represents an effective and safe treatment of chronic HE.

• Authors: C Loguercio, A Federico, V De Girolamo, A Ferrieri, C Del Vecchio Blanco
• Journal: Minerva gastroenterologica e dietologica (Minerva Gastroenterol Dietol) Vol. 49 Issue 1 Pg. 53-62 (Mar 2003) ISSN: 1121-421X [Print] Italy
• PMID: 16481971 (Publication Type: Journal Article)