Title :

Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: a pilot study (RIFA-AH).

Author(s) :

Jiménez, C. [Auteur]
Ventura-Cots, M. [Auteur]
Sala, M. [Auteur]
Calafat, M. [Auteur]
Garcia-Retortillo, M. [Auteur]
Cirera, I. [Auteur]
Cañete, N. [Auteur]
Soriano, G. [Auteur]
Poca, M. [Auteur]
Simón-Talero, M. [Auteur]
Altamirano, J. [Auteur]
Lucey, M. [Auteur]
Garcia-Tsao, G. [Auteur]
Brown, R. S. [Auteur]
Schwabe, R. F. [Auteur]
Verna, E. C. [Auteur]
Schnabl, B. [Auteur]
Bosques-Padilla, F. [Auteur]
Mathurin, Philippe [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Caballería, J. [Auteur]
Louvet, Alexandre [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Shawcross, D. L. [Auteur]
Abraldes, J. G. [Auteur]
Genescà, J. [Auteur]
Bataller, R. [Auteur]
Vargas, V. [Auteur]

Journal title :

Liver International

Abbreviated title :

Liver Int

Publication date :

2022-03-02

ISSN :

1478-3231

English keyword(s) :

acute-on-chronic liver failure
alcohol-related liver disease
bacterial infection
cirrhosis
rifaximin
severe alcoholic hepatitis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

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 ...
Show more >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.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-12T02:11:00Z
2024-03-08T15:32:26Z