A Comparison of Rifaximin with Placebo for the treatment of Hepatic Encephalopathy

Background: The treatment options for HE is majorly based or focuses the cure of episodes as they occur and also directed to reduce the nitrogenous load in the gut. The underlaying drug rifaximin is simply oral absorbable antimicrobial mediator, which is condensed in the gastrointestinal tract. It has broad-spectrum activity i.e. in vitro activity against all gram positive and gram-negative bacteria including aerobic and anaerobic. Methods: The study design opted for the present research was interventional, where the hepatic encephalopathy patients were given randomly rifaximin and placebo treatment. The study duration was of six month from janurary to june 2017. The venue of the study was Lahore general hospital. The exclusion criteria include all patients with liver transplantation, precipitants of hepatic encephalopathy, respiratory problems and anemia whereas all the patients of both genders above 18 years of age with minimum of two evident encephalopathy episodes were included in this study. Results: A total of 120 patients were recruited for this study. The mean age of the patients was 44 +/- 8.9 with range 18-55. The average treatment duration observed in rifaximin group was 128.1+45 whereas in placebo group was 110+61.2 days. We also observed high compliance rate between both groups i.e. 83.2% & 84.1%. We observed the breakthrough episode of HE in 15 (25%) of the patients in rifaximin group where as it is 30(50%) in placebo group. The hazard ratio was 0.39 for the breakthrough episode risk in rifaximin group in comparison to placebo group. Conclusion: We may conclude a robust protective effect of rifaximin alongside episodes of hepatic HE. It also diminishes the risk of hospitalization.