Trial reportPloS one2013
Modulation of the metabiome by rifaximin in patients with cirrhosis and minimal hepatic encephalopathy.
Trial report in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 229 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of Rifaximin Therapy on Brain Activation in Patients With Minimal Hepatic Encephalopathy Using Functional MR, MR Spectroscopy,Diffusion Tensor Imaging Microbiome and Metabolome: a Prospective Trial
A Multicenter, Prospective, Randomized Controlled Study to Explore the Efficacy and Safety of Fecal Microbiota Transplantation With Different Bacterial Doses in the Treatment of Recurrent Hepatic Encephalopathy
Who cites it
229 citing papers in PubMed, 5 syntheses or guidelines pooled it, 414 citations in OpenAlex.
- Antibiotic therapy for small intestinal bacterial overgrowth: a systematic review of comparative efficacy, clinical-test discordance, and pediatric evidence gaps.Frontiers in pharmacology · 2026Pooled it
- Research reviews and prospects of gut microbiota in liver cirrhosis: a bibliometric analysis (2001-2023).Frontiers in microbiology · 2024Pooled it
- Rifaximin for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2023Pooled it
- Systematic review: microbial manipulation as therapy for primary sclerosing cholangitis.Alimentary pharmacology & therapeutics · 2023Pooled it
- Hepatic Encephalopathy in Cirrhotic Patients and Risk of Small Intestinal Bacterial Overgrowth: A Systematic Review and Meta-Analysis.BioMed research international · 2022Pooled it
- Platelet activation and short-term rifaximin therapy in decompensated cirrhosis: a pilot randomized controlled study.Internal and emergency medicine · 2026Trial
- Rifaximin Improves Cognitive Performance and Reduces Cirrhosis-Related Adverse Events in Covert Hepatic Encephalopathy: A Randomized Controlled Trial.Alimentary pharmacology & therapeutics · 2026Trial
- Rifaximin reduces gut-derived inflammation in severe acute pancreatitis: an experimental animal model and randomized controlled trial.Microbiology spectrum · 2025Trial
- The RIVET RCT: Rifamycin SV MMX improves muscle mass, physical function, and ammonia in cirrhosis and minimal encephalopathy.Hepatology communications · 2024Trial
- Reduced alcohol preference and intake after fecal transplant in patients with alcohol use disorder is transmissible to germ-free mice.Nature communications · 2022Trial
- Effects of the antibiotic rifaximin on cortical functional connectivity are mediated through insular cortex.Scientific reports · 2021Trial
- Short-course Rifaximin therapy efficacy and lactulose hydrogen breath test in Chinese patients with diarrhea-predominant irritable bowel syndrome.BMC gastroenterology · 2020Trial
- Microbial functional change is linked with clinical outcomes after capsular fecal transplant in cirrhosis.JCI insight · 2019Trial
- Fecal Microbial Transplant Capsules Are Safe in Hepatic Encephalopathy: A Phase 1, Randomized, Placebo-Controlled Trial.Hepatology (Baltimore, Md.) · 2019Trial
- Selective improvement by rifaximin of changes in the immunophenotype in patients who improve minimal hepatic encephalopathy.Journal of translational medicine · 2019Trial
- Follow-on RifAximin for the Prevention of recurrence following standard treatment of Infection withGut · 2019Trial
- Rifaximin alters gut microbiota profile, but does not affect systemic inflammation - a randomized controlled trial in common variable immunodeficiency.Scientific reports · 2019Trial
- Effects of Rifaximin on Central Responses to Social Stress-a Pilot Experiment.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2018Trial
- Trial
- Fecal microbiota transplant from a rational stool donor improves hepatic encephalopathy: A randomized clinical trial.Hepatology (Baltimore, Md.) · 2017Trial
169 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
unlabelledHepatic encephalopathy (HE) represents a dysfunctional gut-liver-brain axis in cirrhosis which can negatively impact outcomes. This altered gut-brain relationship has been treated using gut-selective antibiotics such as rifaximin, that improve cognitive function in HE, especially its subclinical form, minimal HE (MHE). However, the precise mechanism of the action of rifaximin in MHE is unclear. We hypothesized that modulation of gut microbiota and their end-products by rifaximin would affect the gut-brain axis and improve cognitive performance in cirrhosis. Aim To perform a systems biology analysis of the microbiome, metabolome and cognitive change after rifaximin in MHE.
methodsTwenty cirrhotics with MHE underwent cognitive testing, endotoxin analysis, urine/serum metabolomics (GC and LC-MS) and fecal microbiome assessment (multi-tagged pyrosequencing) at baseline and 8 weeks post-rifaximin 550 mg BID. Changes in cognition, endotoxin, serum/urine metabolites (and microbiome were analyzed using recommended systems biology techniques. Specifically, correlation networks between microbiota and metabolome were analyzed before and after rifaximin.
resultsThere was a significant improvement in cognition(six of seven tests improved, p<0.01) and endotoxemia (0.55 to 0.48 Eu/ml, p = 0.02) after rifaximin. There was a significant increase in serum saturated (myristic, caprylic, palmitic, palmitoleic, oleic and eicosanoic) and unsaturated (linoleic, linolenic, gamma-linolenic and arachnidonic) fatty acids post-rifaximin. No significant microbial change apart from a modest decrease in Veillonellaceae and increase in Eubacteriaceae was observed. Rifaximin resulted in a significant reduction in network connectivity and clustering on the correlation networks. The networks centered on Enterobacteriaceae, Porphyromonadaceae and Bacteroidaceae indicated a shift from pathogenic to beneficial metabolite linkages and better cognition while those centered on autochthonous taxa remained similar.
conclusionsRifaximin is associated with improved cognitive function and endotoxemia in MHE, which is accompanied by alteration of gut bacterial linkages with metabolites without significant change in microbial abundance.
trial registrationClinicalTrials.gov NCT01069133.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.