Trial reportAlimentary pharmacology & therapeutics2015
Prolonged remission from hepatic encephalopathy with rifaximin: results of a placebo crossover analysis.
Trial report in Alimentary pharmacology & therapeutics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 4 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Efficacy and safety of rifaximin for the prophylaxis of hepatic encephalopathy: A meta-analysis.Medicine · 2025Pooled it
- CROATIAN GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF PORTAL HYPERTENSION.Acta clinica Croatica · 2024Guideline
- Efficacy and Safety of Rifaximin in the Prevention of Recurrent Episodes of Hepatic Encephalopathy: A Systematic Review and Meta-analysis.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2023Pooled it
- Systematic Review of the Economic Burden of Overt Hepatic Encephalopathy and Pharmacoeconomic Impact of Rifaximin.PharmacoEconomics · 2018Pooled it
- Low-dose rifaximin prevents complications and improves survival in patients with decompensated liver cirrhosis.Hepatology international · 2021Trial
- Selective improvement by rifaximin of changes in the immunophenotype in patients who improve minimal hepatic encephalopathy.Journal of translational medicine · 2019Trial
- Rifaximin Reduces Markers of Inflammation and Bacterial 16S rRNA in Zambian Adults with Hepatosplenic Schistosomiasis: A Randomized Control Trial.The American journal of tropical medicine and hygiene · 2018Trial
- Rifaximin and Propranolol Combination Therapy Is More Effective than Propranolol Monotherapy for the Reduction of Portal Pressure: An Open Randomized Controlled Pilot Study.Gut and liver · 2017Trial
- Repeat Rifaximin for Irritable Bowel Syndrome: No Clinically Significant Changes in Stool Microbial Antibiotic Sensitivity.Digestive diseases and sciences · 2017Trial
- Reducing the Risk of Overt Hepatic Encephalopathy Recurrence: A Narrative Review.Journal of clinical and translational hepatology · 2026Review
- Rifaximin-induced changes in the gut microbiome associated to improvement of neurotransmission alterations and learning in rats with chronic liver disease.Scientific reports · 2025Article
- Gut-liver axis: Recent concepts in pathophysiology in alcohol-associated liver disease.Hepatology (Baltimore, Md.) · 2024Review
- Extracellular Vesicles from Mesenchymal Stem Cells Reverse Neuroinflammation and Restore Motor Coordination in Hyperammonemic Rats.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2024Article
- Improved cognition after rifaximin treatment is associated with changes in intra- and inter-brain network functional connectivity.Journal of translational medicine · 2024Article
- Neurofilament Light Chain Protein in Plasma and Extracellular Vesicles Is Associated with Minimal Hepatic Encephalopathy and Responses to Rifaximin Treatment in Cirrhotic Patients.International journal of molecular sciences · 2023Article
- Extracellular vesicles from mesenchymal stem cells reduce neuroinflammation in hippocampus and restore cognitive function in hyperammonemic rats.Journal of neuroinflammation · 2023Article
- New Therapies of Liver Diseases: Hepatic Encephalopathy.Journal of clinical medicine · 2021Review
- Cost-Effectiveness of Rifaximin Treatment in Patients with Hepatic Encephalopathy.Journal of managed care & specialty pharmacy · 2020Article
- Microbiome dysbiosis and alcoholic liver diseaseLiver research (Beijing, China) · 2019Article
- Targets to improve quality of care for patients with hepatic encephalopathy: data from a multi-centre cohort.Alimentary pharmacology & therapeutics · 2019Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRifaximin therapy reduced risk of hepatic encephalopathy (HE) recurrence and HE-related hospitalisations during a 6-month, randomised, placebo-controlled trial (RCT) and a 24-month open-label maintenance (OLM) study. However, the impact of crossover from placebo to rifaximin therapy is unclear.
aimTo study the impact of crossing over from placebo to rifaximin treatment on breakthrough HE and hospitalisation rates using a within-subjects design.
methodsAdults with cirrhosis and history of overt HE episodes, currently in HE remission, received placebo during the RCT and crossed over to rifaximin 550 mg twice daily during the OLM study. Rate of breakthrough overt HE episodes, hospitalisations and incidence and rate of adverse events (AEs) were analysed during RCT and first 6 months of OLM.
resultsOf 82 patients randomised to placebo in the RCT who crossed over to the OLM study, 39 experienced an HE episode during the RCT compared with 14 during the OLM study (P < 0.0001). Significantly lower rates of HE events were observed with rifaximin treatment compared with placebo treatment (P < 0.0001). Rates of HE-related hospitalisation were numerically lower during rifaximin treatment compared with placebo treatment, although not significant. Rates of most common AEs, serious AEs and infection-related AEs were similar between the two treatments.
conclusionsThis analysis confirms the repeatability of results from the RCT on safety and efficacy of rifaximin 550 mg twice daily in reducing the risk of hepatic encephalopathy recurrence, and suggests these findings are translatable outside of a rigorous, controlled trial setting.
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