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

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 bacte...

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Autores: Jimenez, C, Ventura-Cots, M, Sala, M, Calafat, M, Garcia-Retortillo, M, Cirera, I, Canete, N, Soriano, G, Poca, M, Simon-Talero, M, Altamirano, J, Lucey, M, Garcia-Tsao, G, Brown, RS, Schwabe, RF, Verna, EC, Schnabl, B, Bosques-Padilla, F, Mathurin, P, Caballeria, J, Louvet, A, Shawcross, DL, Abraldes, JG, Genesca, J, Bataller, R, Vargas, V
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p8089
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8089
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85125671056&doi=10.1111%2fliv.15207&partnerID=40&md5=16f62869cbd77b87a5bc35141cea56fd
Access Level:acceso abierto
Palabra clave:acute-on-chronic liver failure
alcohol-related liver disease
bacterial infection
cirrhosis
rifaximin
severe alcoholic hepatitis
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spelling Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)Jimenez, CVentura-Cots, MSala, MCalafat, MGarcia-Retortillo, MCirera, ICanete, NSoriano, GPoca, MSimon-Talero, MAltamirano, JLucey, MGarcia-Tsao, GBrown, RSSchwabe, RFVerna, ECSchnabl, BBosques-Padilla, FMathurin, PCaballeria, JLouvet, AShawcross, DLAbraldes, JGGenesca, JBataller, RVargas, Vacute-on-chronic liver failurealcohol-related liver diseasebacterial infectioncirrhosisrifaximinsevere alcoholic hepatitisBackground & 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.WILEY2022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8089https://www.scopus.com/inward/record.uri?eid=2-s2.0-85125671056&doi=10.1111%2fliv.15207&partnerID=40&md5=16f62869cbd77b87a5bc35141cea56fdLIVER INTERNATIONALISSN: 14783223ISSNe: 14783231reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p80892026-06-14T12:41:47Z
dc.title.none.fl_str_mv Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
title Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
spellingShingle Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
Jimenez, C
acute-on-chronic liver failure
alcohol-related liver disease
bacterial infection
cirrhosis
rifaximin
severe alcoholic hepatitis
title_short Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
title_full Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
title_fullStr Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
title_full_unstemmed Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
title_sort Effect of rifaximin on infections, acute-on-chronic liver failure and mortality in alcoholic hepatitis: A pilot study (RIFA-AH)
dc.creator.none.fl_str_mv Jimenez, C
Ventura-Cots, M
Sala, M
Calafat, M
Garcia-Retortillo, M
Cirera, I
Canete, N
Soriano, G
Poca, M
Simon-Talero, M
Altamirano, J
Lucey, M
Garcia-Tsao, G
Brown, RS
Schwabe, RF
Verna, EC
Schnabl, B
Bosques-Padilla, F
Mathurin, P
Caballeria, J
Louvet, A
Shawcross, DL
Abraldes, JG
Genesca, J
Bataller, R
Vargas, V
author Jimenez, C
author_facet Jimenez, C
Ventura-Cots, M
Sala, M
Calafat, M
Garcia-Retortillo, M
Cirera, I
Canete, N
Soriano, G
Poca, M
Simon-Talero, M
Altamirano, J
Lucey, M
Garcia-Tsao, G
Brown, RS
Schwabe, RF
Verna, EC
Schnabl, B
Bosques-Padilla, F
Mathurin, P
Caballeria, J
Louvet, A
Shawcross, DL
Abraldes, JG
Genesca, J
Bataller, R
Vargas, V
author_role author
author2 Ventura-Cots, M
Sala, M
Calafat, M
Garcia-Retortillo, M
Cirera, I
Canete, N
Soriano, G
Poca, M
Simon-Talero, M
Altamirano, J
Lucey, M
Garcia-Tsao, G
Brown, RS
Schwabe, RF
Verna, EC
Schnabl, B
Bosques-Padilla, F
Mathurin, P
Caballeria, J
Louvet, A
Shawcross, DL
Abraldes, JG
Genesca, J
Bataller, R
Vargas, V
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv acute-on-chronic liver failure
alcohol-related liver disease
bacterial infection
cirrhosis
rifaximin
severe alcoholic hepatitis
topic acute-on-chronic liver failure
alcohol-related liver disease
bacterial infection
cirrhosis
rifaximin
severe alcoholic hepatitis
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8089
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85125671056&doi=10.1111%2fliv.15207&partnerID=40&md5=16f62869cbd77b87a5bc35141cea56fd
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=8089
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85125671056&doi=10.1111%2fliv.15207&partnerID=40&md5=16f62869cbd77b87a5bc35141cea56fd
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv LIVER INTERNATIONAL
ISSN: 14783223
ISSNe: 14783231
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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