- Twice-daily rifaximin reduces the risk of hepatic encephalopathy (HE) and is associated with a higher rate of transplant-free survival during a 6-month period after placement of a transjugular intrahepatic portosystemic shunt (TIPS).
Why this matters
- More effective strategies are needed to prevent HE, a common complication after creation of a TIPS.
- A total of 144 men and 44 women (mean age, 59.9±9 years) who were treated with TIPS were included in the trial.
- Approximately 20% of patients had experienced ≥1 episode of HE prior to TIPS.
- Patients were randomly assigned to either twice-daily rifaximin 600 mg or placebo, initiated 15 days prior to TIPS and for 6 months following the procedure.
- The probability of remaining free of HE at 6 months comprised the primary endpoint.
- Funding: None reported.
- Mean follow-up period: 310±120 days.
- The primary endpoint was met in 59.1% (95% CI, 49.8-70.2) of patients in the rifaximin group vs 44.2% (95% CI, 34.9-56.1) in the placebo group (P=.05).
- At 6 months, the transplant-free survival rate was 93.2% (95% CI, 88.0-98.6) in the rifaximin group vs 84.0% (95% CI, 76.7-92.1) in the placebo group.
- The study included more men than women.