PMID- 24672094
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140327
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 65
IP  - 5
DP  - 2004 Sep
TI  - Clinical effects of rifaximin in patientswith hepatic encephalopathy intolerant 
      or nonresponsive to previous lactulose treatment: An open-label, pilot study.
PG  - 413-22
LID - 10.1016/j.curtheres.2004.10.002 [doi]
AB  - BACKGROUND: Hepatic encephalopathy (HE) is a metabolic-neurophysiologicsyndrome 
      that occurs in patients with advanced hepatic disease. One of the main pathogenic 
      mechanisms is represented by circulating toxins produced by the intestinal 
      metabolism of nitrogenous compounds. The therapeutic approach to HE is mainly 
      based on drugs that eliminate ammonia-producing bacteria. OBJECTIVES: The aim of 
      this study was to evaluate the effects of the nonabsorbable antibiotic rifaximin 
      in patients with HE who were intolerant or nonresponsive to treatment with an 
      oral, nonabsorbable disaccharide (lactulose). METHODS: This uncontrolled, 
      open-label, pilot study was conducted at the University of Bologna, Bologna, 
      Italy. Patients aged >/= 18 years with histologically proven liver cirrhosis and HE 
      were studied. All patients were intolerant or nonresponsive to previous treatment 
      with lactulose. Rifaximin tablets were administered to patients at a dosage of 
      400 mg TID for 10 days. The portal systemic encephalopathy (PSE) index was 
      evaluated at enrollment and at the end of the treatment period. Tolerability was 
      assessed using hematology, biochemistry, and urinalysis and by recording adverse 
      effects (AEs). RESULTS: Twenty-six patients (18 men, 8 women; mean [SD] age, 55.8 
      [8.0] years) were enrolled (intolerants, n = 17; nonresponders, n = 9). All 
      patients completed the study. Significant improvement was shown in most of the 5 
      components of the PSE index after rifaximin administration in both intolerants 
      and nonresponders. At the end of the 10-day treatment period, the PSE index was 
      significantly reduced in both intolerants and nonresponders. Rifaximin was well 
      tolerated; no clinically relevant AEs were observed during the treatment period. 
      CONCLUSIONS: This pilot study of patients with liver cirrhosis and HE who were 
      intolerant or nonresponsive to previous treatment with an oral, nonabsorbable 
      disaccharide suggests that treatment with rifaximin may be considered as an 
      adjuvant or an alternative treatment in reducing HE.
FAU - Sama, Claudia
AU  - Sama C
AD  - Department of Internal Medicine and Gastroenterology, Alma Mater 
      Studiorum,University of Bologna, Bologna, Italy.
FAU - Morselli-Labate, Antonio Maria
AU  - Morselli-Labate AM
AD  - Department of Internal Medicine and Gastroenterology, Alma Mater 
      Studiorum,University of Bologna, Bologna, Italy.
FAU - Pianta, Paolo
AU  - Pianta P
AD  - Department of Internal Medicine and Gastroenterology, Alma Mater 
      Studiorum,University of Bologna, Bologna, Italy.
FAU - Lambertini, Laura
AU  - Lambertini L
AD  - Department of Internal Medicine and Gastroenterology, Alma Mater 
      Studiorum,University of Bologna, Bologna, Italy.
FAU - Berardi, Sonia
AU  - Berardi S
AD  - Department of Internal Medicine and Gastroenterology, Alma Mater 
      Studiorum,University of Bologna, Bologna, Italy.
FAU - Martini, Gabriella
AU  - Martini G
AD  - Department of Internal Medicine and Gastroenterology, Alma Mater 
      Studiorum,University of Bologna, Bologna, Italy.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3964524
OTO - NOTNLM
OT  - antibiotics
OT  - disaccharides
OT  - drug therapy
OT  - hepatic encephalopathy
OT  - liver cirrhosis
OT  - rifaximin
EDAT- 2004/09/01 00:00
MHDA- 2004/09/01 00:01
PMCR- 2004/09/01
CRDT- 2014/03/28 06:00
PHST- 2004/07/19 00:00 [accepted]
PHST- 2014/03/28 06:00 [entrez]
PHST- 2004/09/01 00:00 [pubmed]
PHST- 2004/09/01 00:01 [medline]
PHST- 2004/09/01 00:00 [pmc-release]
AID - S0011-393X(04)80120-6 [pii]
AID - 10.1016/j.curtheres.2004.10.002 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2004 Sep;65(5):413-22. doi: 
      10.1016/j.curtheres.2004.10.002.