Rifaximin may prevent hepatic encephalopathy after TIPS in patients with cirrhosis

Written By : Hina Zahid |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2021-02-02T05:00:00+05:30 | Updated On 2 Feb 2021 12:29 PM IST

In a randomized controlled trial, the antibiotic rifaximin used before and after transjugular intrahepatic portosystemic shunt (TIPS) placement, a minimally invasive procedure for treating portal hypertension-related complications of cirrhosis, helped to prevent hepatic encephalopathy compared to placebo. Adverse events were similar in both groups. The findings are published in Annals of Internal Medicine.

Potential complications of TIPS include shunt dysfunction and the development of hepatic encephalopathy. The rate of shunt dysfunction has been dramatically reduced by the use of polytetrafluoroethylene-covered stents, but hepatic encephalopathy still occurs in 35% to 50% of patients. According to U.S. and European guidelines published in 2014, no prophylactic therapy is recommended to prevent overt hepatic encephalopathy after TIPS placement in these patients.

Researchers from University Hospital of Toulouse France and Toulouse III Paul Sabatier University randomly assigned 197 patients with cirrhosis undergoing TIPS to receive either rifaximin or placebo beginning 14 days before the procedure and continuing 168 days after to determine if rifaximin would prevent overt hepatic encephalopathy. An episode of overt hepatic encephalopathy occurred in 34% of patients in the rifaximin group and 53% in the placebo group during the postprocedure period. Neither the incidence of adverse events nor transplant-free survival was significantly different between the two groups. According to the researchers, this study supports the use of rifaximin to prevent post-TIPS overt hepatic encephalopathy in patients with cirrhosis.

https://www.acpjournals.org/doi/10.7326/M20-0202

rifaximinhepatic encephalopathycirrhosisannals of internal medicinetransjugular intrahepatic portosystemic shunt

Source : Annals of Internal Medicine

Hina Zahid

Hina Zahid Joined Medical Dialogue in 2017 with a passion to work as a Reporter. She coordinates with various national and international journals and association and covers all the stories related to Medical guidelines, Medical Journals, rare medical surgeries as well as all the updates in the medical field. Email: editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751