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

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dc.contributor.author Jiménez, César
dc.contributor.author Garcia-Retortillo, Montserrat
dc.contributor.author Cirera Lorenzo, Isabel
dc.contributor.author Cañete Hidalgo, Nuria
dc.contributor.author Vargas, Víctor
dc.date.accessioned 2022-10-07T06:25:34Z
dc.date.available 2022-10-07T06:25:34Z
dc.date.issued 2022
dc.identifier.citation Jiménez C, Ventura-Cots M, Sala M, Calafat M, Garcia-Retortillo M, Cirera I et al. Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH). Liver Int. 2022 May;42(5):1109-20. DOI: 10.1111/liv.15207
dc.identifier.issn 1478-3223
dc.identifier.uri http://hdl.handle.net/10230/54305
dc.description.abstract 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.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartof Liver Int. 2022 May;42(5):1109-20
dc.rights © 2022 The Authors. Liver International published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.title Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1111/liv.15207
dc.subject.keyword Acute-on-chronic liver failure
dc.subject.keyword Alcohol-related liver disease
dc.subject.keyword Bacterial infection
dc.subject.keyword Cirrhosis
dc.subject.keyword Rifaximin
dc.subject.keyword Severe alcoholic hepatitis
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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