Outcome of patients taking rifaxamine Vs lactose in patients with hepatic encephalopathy presenting at tertiary care hospital sukkur
DOI:
https://doi.org/10.48047/yxbgmq37Keywords:
Outcome; Rifaxamine; lactose; Hepatic encephalopathyAbstract
Background: Hepatic encephalopathy is a significant consequence of degenerative chronic liver disease. If not properly controlled, it can lead to higher death rates.
Objective: The objective of this study was to compare the Outcome of patients taking rifaxamine Vs lactose in patients with hepatic encephalopathy presenting at tertiary care hospital sukkur.
Material and method: The current randomized controlled study was conducted at the department of gastroenterology Ghulamm Muhammad Mahar medical college sukkur from January 2023 to January 2024 after taking permission from the ethical board of the institute. A total of 396 individuals of both genders and different aged groups diagnosed with acute hepatic encephalopathy (grade 1 to 3) were included. 9 The study participants were randomly assigned to one of two groups: Group A 198 received Rifaxamin 550mg twice day, while Group B 198 received Lactulose 30-90ml daily. Basic demographic information, including name, age, gender, residence, and contact information, were collected. The data was analyzed statistically with SPSS version 16. Quantitative factors such as age were expressed as mean ± SD. Qualitative characteristics such as gender and improvement in HE grade were presented as frequencies and percentages. The chi-square test was performed to examine the prevalence of improvements in HE grade across both groups. P-values < 0.05 were regarded as significant.
Results: In the current study a total of 196 individuals were enrolled. The study participants were randomly assigned to one of two groups: Group A 198 received Rifaxamin 550mg twice day, while Group B 198 received Lactulose 30-90ml daily. Age distribution of participants revealed that 77 (39%) in Group-A and 85 (43%) in Group-B were within 30-50 years of age, while 121 (61%) in Group-A and 113 (57%) in Group-B were within 51-70 years of age. The mean and standard deviation was determined as 44.80+14.72 and 44.23+14.75 years, respectively. The gender distribution of patients was as follows: 101 (49%) in Group-A and 96 (48.4%) in Group-B were men, while 97 (51%) in Group-A and 102 (51.6%) in Group-B were females. Rifaximin and Lactulose improved hepatic encephalopathy grades in 136 (76%) and 131 (72%), respectively. However, 40 (24%) and 49 (28%) in Group-A and Group-B did not demonstrated any improvement, with a p-value of significance >0.05.
Conclusion: The current study concluded that Rifaximin and Lactulose showed equivalent effectiveness in treating mild to severe hepatic encephalopathy
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References
Detlef Schuppan, Nezam H Afdhal. Liver cirrhosis. The Lancet, 2008;371:838-51
Lavanchy D. The global burden of hepatitis C. Liver Int. 2009 Jan;29 Suppl 1:74-81.
National Vital Statistics Reports. Centers for Disease Control and Prevention 2013;61:3-5.
Ali M, Idrees M, Ali L, Hussain A, Ur Rehman I, Saleem S, Afzal S, Butt S. Hepatitis B virus in Pakistan: a systematic review of prevalence, risk factors, awareness status and genotypes. Virol J. 2011; 8:102
Cash WJ, McConville P, McDermott E, McCormick PA, Callender ME, McDougall NI. Current concepts in the assessment and treatment of hepatic encephalopathy. QJM 2010; 103: 9–16
.Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei A. Hepaticencephalopathy--definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 2002; 35: 716-21
Coltart, I, Tranah, T.H, Shawcross, DL. Inflammation and hepatic encephalopathy Arch Biochem Biophys 2013; 536: 189–96
Sharma BC, Sharma P, Lunia MK, Srivastava S, Goyal R, Sarin SK. A randomized, double blind, controlled trial comparing rifaximin plus lactulose with lactulose alone in treatment of overt hepatic encephalopathy
.Munoz SJ. Hepatic encephalopathy.Med Clin North Am. 2008; 92(4):795-812, viii
.Raja NS, Janjua KA. Epedemiology of hepatitis C virus infection in Pakistan.J Microbiol Immunol Infect 2008; 41:4-8
.Paik YH, Lee KS, Han KH, Song KH, Kim MH, Moon BS, et al. Comparison of rifaximin and lactulose for the treatment of hepatic encephalopathy: a prospective randomized study.Yonsei Med J. 2005; 46(3):399-407
.Jiang Q, Jiang XH, Zheng MH, Jiang LM, Chen YP, Wang L. Rifaximin versus non-absorbable disaccharides in the management of hepatic encephalopathy: a metaanalysis.Eur J Gastroenterol Hepatol 20S08; 20:1064-70.
Zullo A, Hassan C, Ridola L, Lorenzetti R, Salvatore MA, Riggio O. Rifaximin therapy and hepatic encephalopathy: Pros and cons.World J Gastrointest Pharamcol Ther 2012; 3:62-7
Ali B, Abbas Y, Alam A, Sohail H A, Efficacy of Rifaximin in prevention of recurrence of hepatic encephalopathy in patients with cirrhosis of liver.J of the CPSP 2014; 24 : 269-273
Lawrence KR, Klee JA. Rifaximin for the treatment of hepatic encephalopathy.Pharmacotherapy. 2008; 28(8): 1019-32
Leevy CB, Phillips JA. Hospitalizations during the use of rifaximin versus lactulose for the treatment of hepatic encephalopathy.Dig Dis Sci 2007; 52:737-41.
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