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Rifaximin has no effect on hemodynamics in decompensated cirrhosis - A randomized, double blind, placebo controlled trial


, : Rifaximin has no effect on hemodynamics in decompensated cirrhosis - A randomized, double blind, placebo controlled trial. Hepatology (): -

Decompensated cirrhosis is characterized by disturbed systemic and splanchnic hemodynamics. Bacterial translocation from the gut is considered the key driver in this process. Intestinal decontamination with rifaximin may improve hemodynamics. This double-blind, randomized, controlled trial investigates the effects of rifaximin on hemodynamics, renal function and vasoactive hormones. We randomized 54 stable out-patients with cirrhosis and ascites to rifaximin 550 mg BD (n=36) or placebo BD (n=18). Forty-five patients were male, mean age 56 years (±8.4), the average Child score 8.3 (±1.3), and the MELD score 11.7 (±3.9). Measurements of hepatic venous pressure gradient (HVPG), cardiac output, and systemic vascular resistance (SVR) were performed at baseline and after 4 weeks. The glomerular filtration rate (GFR), plasma renin, noradrenaline, lipo-polysaccharide binding protein (LBP), troponin T and brain natriuretic peptide levels were measured. Rifaximin had no effect on HVPG, mean 16.8 ±3.8 mmHg at baseline vs. 16.6 ±5.3 mmHg at follow-up compared to the placebo, mean 16.4 ±4 mmHg at baseline vs. 16.3 ±4.4 mmHg at follow-up, p=0.94. No effect was found on the cardiac output, mean 6.9 ±1.7 l/min at baseline vs. 6.9 ±2.3 l/min at follow-up compared to the placebo, mean 6.6 ±1.9 l/min at baseline compared to 6.5 ±2.1 l/min at follow-up, p=0.66. No effects on the GFR p=0.14 or the vasoactive hormones were found. Subgroup analyses on patients with increased LBP and SVR below the mean (1011 dynes x s/cm5 ) revealed no effect of rifaximin. Four weeks of treatment with rifaximin did not reduce the HVPG or improve systemic hemodynamics in patients with cirrhosis and ascites. Rifaximin did not affect GFR or levels of vasoactive hormones. ClinicalTrials.gov (NCT01769040). This article is protected by copyright. All rights reserved.

US$19.90

PMID: 27775818

DOI: 10.1002/hep.28898


Other references

Ware, A.J.; Cuthbert, J.A.; Shorey, J.; Gurian, L.E.; Eigenbrodt, E.H.; Combes, B., 1981: A prospective trial of steroid therapy in severe viral hepatitis. The prognostic significance of bridging necrosis. A prospective, double-blinded, randomized trial of corticosteroid therapy in patients with severe acute viral hepatitis has been conducted. At the same time, we have examined the prognostic significance of the presence of bridging necrosis in live...

Natarajan, U.S.; Raja, V.D.G.; Selvaraj, S.; Parambaramani, C., 1974: Grain loss due to ergot disease in bajra hybrids. Data are presented on grain loss due to ergot (Claviceps microcephala) in 18 Pennisetum typhoides cvs. Av. disease incidence was 62.4% with 58.4% grain loss. There were no significant differences for either parameter among the entries, all of whic...

Trivelpiece, WZ.; Trivelpiece, SG.; Geupel, GR.; Kjelmyr, J.; Volkman, NJ., 1990: Adelie and chinstrap penguins their potential as monitors of the Southern Ocean marine ecosystem. Unknown

Pidgeon, C., 1990: Solid phase membrane mimetics: immobilized artificial membranes. The studies discussed demonstrate the importance of developing rapid methods to purify membrane proteins and also quantitate binding events between cell membranes and biomolecules. Traditional equilibrium methods are experimentally very difficult...

Ye, T.; Zhen, J.; Du, Y.; Zhou, J.K.; Peng, A.; Vaziri, N.D.; Mohan, C.; Xu, Y.; Zhou, X.J., 2016: Green tea polyphenol (-)-epigallocatechin-3-gallate restores Nrf2 activity and ameliorates crescentic glomerulonephritis. Crescentic glomerulonephritis (GN) is the most severe form of GN and is associated with significant morbidity and mortality despite aggressive immunotherapy with steroids, cytotoxic drugs, and plasmapheresis. We examined the therapeutic efficacy o...

Docquier, F.; Rapoport, H., 2002: Are migrant minorities strategically self-selected?. "In this paper we focus on the possibility of migrants' self-selection through strategic remittances. We argue that migrants of a specific community might be pooled with migrants from other ethnic minorities on the labor market of the fo...

Trute, B.; Macpherson, A.S., 1977: Psychiatric teams: the sport of mental health practice. Canada's Mental Health 25(4): 15-17

Costumero, V.; Barrós-Loscertales, A.; Bustamante, J.Carlos.; Ventura-Campos, N.; Fuentes, P.; Rosell-Negre, P.; Ávila, César., 2014: Reward sensitivity is associated with brain activity during erotic stimulus processing. The behavioral approach system (BAS) from Gray's reinforcement sensitivity theory is a neurobehavioral system involved in the processing of rewarding stimuli that has been related to dopaminergic brain areas. Gray's theory hypothesizes t...

Carpenter, R.E.; Ashworth, D.N., 1982: Changing role of hospital boards: analysis of a triad member's perceptions. Journal of Health Care Marketing 1(3): 44-50

Falardeau P.; Hui R., 1991: Inhibition of diacylglycerol formation by eicosapentaenoic acid. Hypertension (Dallas) 18(3): 406