Long-Term Efficacy and Safety of Rifaximin in Japanese Patients with Hepatic Encephalopathy: A Multicenter Retrospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Ethics
2.3. Data Collection
2.4. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Efficacy of Long-Term Rifaximin Use
3.3. Safety of Long-Term Rifaximin Use
3.4. The Efficacy and Safety of Long-Term Rifaximin Use in Patients with Child–Pugh C
3.5. Risk Factors of HE Occurrence during Rifaximin Treatment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | (n = 215) |
---|---|
Age (years) | 69.7 ± 11.6 |
Sex (male/female) | 138/77 |
Body mass index (kg/m2) | 24.8 ± 4.7 |
Etiology (HBV/HCV/Alcohol/NASH/others) | 22/37/66/29/61 |
Child–Pugh (A/B/C) | 14/174/27 |
History of hepatic encephalopathy (yes/no) | 163/52 |
Presence of overt hepatic encephalopathy (yes/no) | 34/181 |
Administration of lactulose (yes/no) | 116/99 |
Presence of esophagogastric varices (yes/no) | 119/96 |
Presence of a portosystemic shunt (yes/no/unknown) | 107/106/2 |
Presence of splenomegaly (yes/no/splenectomy) | 160/54/1 |
Presence of ascites (yes/no) | 79/136 |
Presence of spontaneous bacterial peritonitis (yes/no) | 0/215 |
Presence of hepatocellular carcinoma (yes/no) | 74/141 |
Stage of hepatocellular carcinoma (1/2/3/4) | 27/30/11/6 |
Variables | (n = 215) |
---|---|
Hemoglobin (g/dL) | 11.8 ± 2.1 |
Platelet (×104/μL) | 10.9 ± 5.7 |
Prothrombin activity (%) | 68.5 ± 17.3 |
Serum albumin (g/dL) | 3.2 ± 0.5 |
Aspartate aminotransferase (U/L) | 46.7 ± 24.9 |
Alanine aminotransferase (U/L) | 29.7 ± 15.9 |
Total bilirubin (mg/dL) | 1.6 ± 1.2 |
Serum ammonia (μg/dL) | 102.9 ± 59.1 |
Blood urine nitrogen (mg/dL) | 17.3 ± 9.7 |
Serum creatine (mg/dL) | 0.8 ± 0.3 |
Estimated glomerular filtration (mL/min/1.73 m2) | 72.8 ± 27.0 |
Serum sodium (mEq/L) | 139.2 ± 3.4 |
Serum potassium (mEq/L) | 4.2 ± 0.5 |
ALBI score | −1.72 ± 0.57 |
MELD score | 11.0 ± 3.3 |
Variables | Univariate | Multivariate | ||
---|---|---|---|---|
HR (95% CI) | p-Value | HR (95% CI) | p-Value | |
Age (per year increase) | 1.00 (0.96–1.03) | 0.909 | ||
Sex (male) | 0.52 (0.24–1.12) | 0.094 | 0.61 (0.27–1.37) | 0.234 |
Etiology (HCV vs. except HCV) | 0.71 (0.28–1.78) | 0.464 | ||
Child–Pugh C (vs. A, B) | 1.66 (0.63–4.41) | 0.307 | ||
Presence of esophagogastric varices | 1.28 (0.58–2.82) | 0.542 | ||
Presence of a portosystemic shunt | 2.42 (1.05–5.58) | 0.037 | 1.68 (0.68–4.13) | 0.262 |
Presence of splenomegaly | 1.02 (0.41–2.56) | 0.965 | ||
Presence of ascites | 1.21 (0.53–2.76) | 0.645 | ||
Presence of HCC | 2.32 (0.87–6.15) | 0.091 | 1.92 (0.69–5.32) | 0.209 |
Stage of HCC | 1.13 (0.49–2.94) | 0.724 | ||
Alanine aminotransferase at baseline | 1.00 (0.97–1.02) | 0.735 | ||
Blood urine nitrogen at baseline | 1.01 (0.98–1.05) | 0.548 | ||
Creatinine at baseline | 1.33 (0.47–3.78) | 0.592 | ||
Serum sodium at baseline | 1.06 (0.94–1.20) | 0.323 | ||
Serum albumin at baseline | 0.44 (0.21–0.90) | 0.025 | 0.58 (0.23–1.44) | 0.241 |
Total bilirubin at baseline | 1.14 (0.88–1.49) | 0.316 | ||
Prothrombin activity at baseline | 0.96 (0.95–0.99) | <0.001 | 0.98 (0.95–1.00) | 0.049 |
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Kawaratani, H.; Kondo, Y.; Tatsumi, R.; Kawabe, N.; Tanabe, N.; Sakamaki, A.; Okumoto, K.; Uchida, Y.; Endo, K.; Kawaguchi, T.; et al. Long-Term Efficacy and Safety of Rifaximin in Japanese Patients with Hepatic Encephalopathy: A Multicenter Retrospective Study. J. Clin. Med. 2022, 11, 1571. https://doi.org/10.3390/jcm11061571
Kawaratani H, Kondo Y, Tatsumi R, Kawabe N, Tanabe N, Sakamaki A, Okumoto K, Uchida Y, Endo K, Kawaguchi T, et al. Long-Term Efficacy and Safety of Rifaximin in Japanese Patients with Hepatic Encephalopathy: A Multicenter Retrospective Study. Journal of Clinical Medicine. 2022; 11(6):1571. https://doi.org/10.3390/jcm11061571
Chicago/Turabian StyleKawaratani, Hideto, Yasuteru Kondo, Ryoji Tatsumi, Naoto Kawabe, Norikazu Tanabe, Akira Sakamaki, Kazuo Okumoto, Yoshihito Uchida, Kei Endo, Takumi Kawaguchi, and et al. 2022. "Long-Term Efficacy and Safety of Rifaximin in Japanese Patients with Hepatic Encephalopathy: A Multicenter Retrospective Study" Journal of Clinical Medicine 11, no. 6: 1571. https://doi.org/10.3390/jcm11061571