首页|Rifaximin vs conventional oral therapy for hepatic encephalopathy: A meta-analysis

Rifaximin vs conventional oral therapy for hepatic encephalopathy: A meta-analysis

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AIM:To characterize the efficacy of rifaximin in the management of hepatic encephalopathy (HE) as several randomized controlled studies have shown contradictory results on its effectiveness in comparison to other oral agents.METHODS:We performed a systematic review and random effects meta-analysis of all eligible trials identified through electronic and manual searches.Twelve randomized controlled trials met the inclusion criteria with a total of 565 patients.RESULTS:The clinical effectiveness of rifaximin was equivalent to disaccharides or other oral antibiotics [odds ratio (OR) 0.96; 95％ CI:0.94-4.08] but with a better safety profile (OR 0.27; 95％ CI:0.12-0.59).At the completion of treatment protocols,patients receiving rifaximin showed lower serum ammonia levels [weighted mean difference (WMD) =-10.65; 95％CI:-23.4-2.1; P =0.10],better mental status (WMD =-0.24; 95％ CI:-0.57-0.08; P =0.15) and less asterixis (WMD-0.1; 95％ CI-0.26-0.07; P =0.25)without reaching statistical significance.On the other hand,other psychometric outcomes such as electroencephalographic response and grades of portosystemic encephalopathy were superior in patients treated with rifaximin in comparison to the control group (WMD =0.21,95％ CI:-0.33-0.09,P =0.0004; and WMD =-2.33,95％ CI:-2.68-1.98,P =0.00001,respectively).Subgroup and sensitivity analysis did not show any significant difference in the above findings.CONCLUSION:Rifaximin appears to be at least as effective as other conventional oral agents for the treatment of HE with a better safety profile.

Hepatic encephalopathyLactuloseNeomycinNon-absorbable disaccharidesRifaximin

Karim M Eltawil、Marie Laryea、Kevork Peltekian、Michele Molinari

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Department of Surgery and Transplantation, Queen Elizabeth Ⅱ Health Sciences Center,Dalhousie University, Halifax, Nova Scotia B3H 2Y9, Canada

Department of Medicine, Hepatology and Transplantation, Queen Elizabeth Ⅱ Health Sciences Center,Dalhousie University, Halifax, Nova Scotia B3H 2Y9, Canada

2012

10.3748/wjg.v18.i8.767

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(8)
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