Comparison of rifaximin and lactulose for the treatment of hepatic encephalopathy: A prospective randomized study

Yong Han Paik, Kwan Sik Lee, Kwang Hyub Han, Kun Hoon Song, Myoung Hwan Kim, Byung Soo Moon, Sang Hoon Ahn, Se Joon Lee, Hyo Jin Park, Dong Ki Lee, Chae Yoon Chon, Sang In Lee, Young Myoung Moon

Research output: Contribution to journalArticle

87 Citations (Scopus)

Abstract

Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe. However, it is unknown whether Rifaximin is effective for the treatment of HE in Koreans, therefore we conducted a open-label prospective randomized study to evaluate the efficacy of rifaximin versus lactulose in Korean patients. Fifty-four patients with liver cirrhosis and hepatic encephalopathy were enrolled. Thirty-two patients were randomized to receive rifaximin and 22 to receive lactulose both over a 7-day periods. Before and at the end of treatment, gradation of blood ammonia, flapping tremor, mental status, number connection test (NCT) were performed and estimation of HE indexes determined. Both rifaximin and lactulose were effective in the majority of patients (84.4% and 95.4%, respectively, p=0.315). Blood NH3, flapping tremor, mental status, and NCT was significantly improved by rifaximin and lactulose, and the post-treatment levels of these measures were similar for the rifaximin and lactulose-treated groups, as was the HE index (rifaximin group (10.0→4.2, p=0.000); lactulose group (11.3 →5.0, p=0.000)). One patient treated with rifaximin complained of abdominal pain, which was easily controlled. There was no episode of renal function impairment in either treatment group. Rifaximin proved to be as safe and as effective as lactulose for the treatment of Korean patients with hepatic encephalopathy.

Original languageEnglish
Pages (from-to)399-407
Number of pages9
JournalYonsei medical journal
Volume46
Issue number3
DOIs
Publication statusPublished - 2005 Jun 30

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rifaximin
Lactulose
Hepatic Encephalopathy
Prospective Studies
Therapeutics
Tremor
Ammonia
Liver Cirrhosis
Abdominal Pain

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Paik, Yong Han ; Lee, Kwan Sik ; Han, Kwang Hyub ; Song, Kun Hoon ; Kim, Myoung Hwan ; Moon, Byung Soo ; Ahn, Sang Hoon ; Lee, Se Joon ; Park, Hyo Jin ; Lee, Dong Ki ; Chon, Chae Yoon ; Lee, Sang In ; Moon, Young Myoung. / Comparison of rifaximin and lactulose for the treatment of hepatic encephalopathy : A prospective randomized study. In: Yonsei medical journal. 2005 ; Vol. 46, No. 3. pp. 399-407.
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abstract = "Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe. However, it is unknown whether Rifaximin is effective for the treatment of HE in Koreans, therefore we conducted a open-label prospective randomized study to evaluate the efficacy of rifaximin versus lactulose in Korean patients. Fifty-four patients with liver cirrhosis and hepatic encephalopathy were enrolled. Thirty-two patients were randomized to receive rifaximin and 22 to receive lactulose both over a 7-day periods. Before and at the end of treatment, gradation of blood ammonia, flapping tremor, mental status, number connection test (NCT) were performed and estimation of HE indexes determined. Both rifaximin and lactulose were effective in the majority of patients (84.4{\%} and 95.4{\%}, respectively, p=0.315). Blood NH3, flapping tremor, mental status, and NCT was significantly improved by rifaximin and lactulose, and the post-treatment levels of these measures were similar for the rifaximin and lactulose-treated groups, as was the HE index (rifaximin group (10.0→4.2, p=0.000); lactulose group (11.3 →5.0, p=0.000)). One patient treated with rifaximin complained of abdominal pain, which was easily controlled. There was no episode of renal function impairment in either treatment group. Rifaximin proved to be as safe and as effective as lactulose for the treatment of Korean patients with hepatic encephalopathy.",
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Comparison of rifaximin and lactulose for the treatment of hepatic encephalopathy : A prospective randomized study. / Paik, Yong Han; Lee, Kwan Sik; Han, Kwang Hyub; Song, Kun Hoon; Kim, Myoung Hwan; Moon, Byung Soo; Ahn, Sang Hoon; Lee, Se Joon; Park, Hyo Jin; Lee, Dong Ki; Chon, Chae Yoon; Lee, Sang In; Moon, Young Myoung.

In: Yonsei medical journal, Vol. 46, No. 3, 30.06.2005, p. 399-407.

Research output: Contribution to journalArticle

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T1 - Comparison of rifaximin and lactulose for the treatment of hepatic encephalopathy

T2 - A prospective randomized study

AU - Paik, Yong Han

AU - Lee, Kwan Sik

AU - Han, Kwang Hyub

AU - Song, Kun Hoon

AU - Kim, Myoung Hwan

AU - Moon, Byung Soo

AU - Ahn, Sang Hoon

AU - Lee, Se Joon

AU - Park, Hyo Jin

AU - Lee, Dong Ki

AU - Chon, Chae Yoon

AU - Lee, Sang In

AU - Moon, Young Myoung

PY - 2005/6/30

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N2 - Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe. However, it is unknown whether Rifaximin is effective for the treatment of HE in Koreans, therefore we conducted a open-label prospective randomized study to evaluate the efficacy of rifaximin versus lactulose in Korean patients. Fifty-four patients with liver cirrhosis and hepatic encephalopathy were enrolled. Thirty-two patients were randomized to receive rifaximin and 22 to receive lactulose both over a 7-day periods. Before and at the end of treatment, gradation of blood ammonia, flapping tremor, mental status, number connection test (NCT) were performed and estimation of HE indexes determined. Both rifaximin and lactulose were effective in the majority of patients (84.4% and 95.4%, respectively, p=0.315). Blood NH3, flapping tremor, mental status, and NCT was significantly improved by rifaximin and lactulose, and the post-treatment levels of these measures were similar for the rifaximin and lactulose-treated groups, as was the HE index (rifaximin group (10.0→4.2, p=0.000); lactulose group (11.3 →5.0, p=0.000)). One patient treated with rifaximin complained of abdominal pain, which was easily controlled. There was no episode of renal function impairment in either treatment group. Rifaximin proved to be as safe and as effective as lactulose for the treatment of Korean patients with hepatic encephalopathy.

AB - Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe. However, it is unknown whether Rifaximin is effective for the treatment of HE in Koreans, therefore we conducted a open-label prospective randomized study to evaluate the efficacy of rifaximin versus lactulose in Korean patients. Fifty-four patients with liver cirrhosis and hepatic encephalopathy were enrolled. Thirty-two patients were randomized to receive rifaximin and 22 to receive lactulose both over a 7-day periods. Before and at the end of treatment, gradation of blood ammonia, flapping tremor, mental status, number connection test (NCT) were performed and estimation of HE indexes determined. Both rifaximin and lactulose were effective in the majority of patients (84.4% and 95.4%, respectively, p=0.315). Blood NH3, flapping tremor, mental status, and NCT was significantly improved by rifaximin and lactulose, and the post-treatment levels of these measures were similar for the rifaximin and lactulose-treated groups, as was the HE index (rifaximin group (10.0→4.2, p=0.000); lactulose group (11.3 →5.0, p=0.000)). One patient treated with rifaximin complained of abdominal pain, which was easily controlled. There was no episode of renal function impairment in either treatment group. Rifaximin proved to be as safe and as effective as lactulose for the treatment of Korean patients with hepatic encephalopathy.

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