Efficacy and Tolerability of Rifaximin in Combination With Lactulose in End-stage Liver Disease Patients With MELD Greater Than 20: A Single Center Experience

Mantry, Parvez S.; Mehta, Ashwini; Graydon, Ryan

doi:10.1016/j.transproceed.2014.10.021

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…A single-centre retrospective study reported that patients with more severe liver disease (i.e. Model for End-Stage Liver Disease (MELD) score > 20; n = 43) receiving rifaximin plus lactulose for ≥ 6 months had a lower mean number of HE-related hospitalizations than did patients with a MELD score < 20 ( n = 49; 1.6 vs. 2.5 hospitalizations, respectively) [ 46 ]. However, retrospective analysis of a US pharmacy claims database (1 January 2006 through 30 June 2015) found no difference in overt HE-related hospitalizations between rifaximin plus lactulose vs. lactulose monotherapy (16.0 vs. 15.3%, respectively; p = 0.8) [ 47 ].…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of the Economic Burden of Overt Hepatic Encephalopathy and Pharmacoeconomic Impact of Rifaximin

Neff

Zachry²

2018

PharmacoEconomics

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BackgroundHepatic encephalopathy (HE), a common neurologic complication in cirrhosis, is associated with substantial disease and economic burden. Rifaximin is a non-systemic antibiotic that reduces the risk of overt HE recurrence and overt HE-related hospitalizations.ObjectiveOur objective was to provide an overview of the direct HE-related costs and cost benefits of rifaximin, lactulose, and rifaximin plus lactulose.MethodsA systematic review of PubMed and relevant meeting abstracts was conducted to identify publications since 1 January 2007 reporting economic data related to HE and rifaximin and/or lactulose. Further, a public database and published literature were used to estimate current costs of hospitalization for overt HE, and potential cost savings of HE-related hospitalizations with rifaximin. The methodological quality of included studies was evaluated using the Drummond checklist.ResultsA total of 16 reports were identified for inclusion in the systematic review. Globally, HE-related direct costs ranged from $US5370 to $US50,120 annually per patient. Rifaximin was associated with shorter hospital stays and reduced healthcare costs. Rifaximin also has the potential to reduce overt HE-related hospitalization risk by 50% compared with lactulose. Rifaximin was shown to have a favourable pharmacoeconomic profile compared with lactulose (based on the incremental cost-effectiveness ratio).ConclusionsIn addition to its clinical benefits (e.g. reduction in the risk of recurrence of overt HE, overt HE-related hospitalizations, favourable adverse event profile), economic data are favourable for the use of rifaximin in patients with a history of overt HE.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of the Economic Burden of Overt Hepatic Encephalopathy and Pharmacoeconomic Impact of Rifaximin

Neff

Zachry²

2018

PharmacoEconomics

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“…In both groups, response to rifaximin appeared to be enhanced in patients with a mean baseline model for end-stage liver disease score of less than or equal to 20 31. These findings appear to contrast with those of a single-center, retrospective, observational study of 225 patients evaluated for liver transplantation, all of whom were treated with rifaximin-α 550 mg+lactulose for 6 months, which showed a lower rate of HE-related hospitalization in patients with a model for end-stage liver disease score of at least 20 versus less than 20 (1.6 vs. 2.5 per 6 months) 29.…”

Section: Resultsmentioning

confidence: 57%

Long-term management of hepatic encephalopathy with lactulose and/or rifaximin: a review of the evidence

Hudson

Schuchmann²

2019

European Journal of Gastroenterology &Amp; Hepatology

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A consolidated overview of evidence for the effectiveness and safety/tolerability of hepatic encephalopathy (HE) treatment over the long term is currently lacking. We identified and assessed published evidence for the long-term (≥6 months) pharmacological management of HE with lactulose and/or rifaximin. A literature search was conducted in PubMed (cutoff date 05 March 2018) using the search terms ‘hepatic encephalopathy+rifaximin’ and ‘hepatic encephalopathy+lactulose’. All articles containing primary clinical data were manually assessed to identify studies in which long-term (≥6 months) effectiveness and/or safety/tolerability end points were reported for lactulose and/or rifaximin. Long-term effectiveness outcomes were reported in eight articles for treatment with lactulose alone and 19 articles for treatment with rifaximin, alone or in combination with lactulose. Long-term safety/tolerability outcomes were reported in six articles for treatment with lactulose alone and nine articles for treatment with rifaximin, alone or in combination with lactulose. These studies showed that lactulose is effective for the prevention of overt HE recurrence over the long term and that the addition of rifaximin to lactulose significantly reduces the risk of overt HE recurrence and HE-related hospitalization, compared with lactulose therapy alone, without compromising tolerability. Current evidence therefore supports recommendations for the use of lactulose therapy for the prevention of overt HE recurrence over the long term, and for the additional benefit of adding rifaximin to lactulose therapy. Addition of rifaximin to standard lactulose therapy may result in substantial reductions in healthcare resource utilization over the long term, by reducing overt HE recurrence and associated rehospitalization.

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An anodically pretreated boron-doped diamond electrode surface for square-wave adsorptive stripping voltammetric quantification of the non-absorbable antibiotic rifaximin in the pharmaceutical formulation

Barzani

Ali

Yardım

2023

Diamond and Related Materials

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Efficacy and Tolerability of Rifaximin in Combination With Lactulose in End-stage Liver Disease Patients With MELD Greater Than 20: A Single Center Experience

Cited by 5 publications

References 33 publications

Systematic Review of the Economic Burden of Overt Hepatic Encephalopathy and Pharmacoeconomic Impact of Rifaximin

Systematic Review of the Economic Burden of Overt Hepatic Encephalopathy and Pharmacoeconomic Impact of Rifaximin

Long-term management of hepatic encephalopathy with lactulose and/or rifaximin: a review of the evidence

An anodically pretreated boron-doped diamond electrode surface for square-wave adsorptive stripping voltammetric quantification of the non-absorbable antibiotic rifaximin in the pharmaceutical formulation

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