The impact of rifaximin on inflammation and metabolism in alcoholic hepatitis: A randomized clinical trial

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  • Nina Kimer, Københavns Universitet
  • ,
  • Mads Meldgaard, Københavns Universitet
  • ,
  • Ole Hamberg, Københavns Universitet
  • ,
  • Thit Mynster Kronborg, Københavns Universitet
  • ,
  • Allan M. Lund, Københavns Universitet
  • ,
  • Holger Jon Moller
  • Flemming Bendtsen, Københavns Universitet
  • ,
  • Henriette Ytting, Københavns Universitet

Background and aims Alcoholic hepatitis (AH) is characterized by acute liver failure, neurocognitive impairment and renal failure. Severe inflammatory reactions are also known to occur in AH. Inflammation and bacterial translocation in the gut are thought to have major impact on disease development and progression. The mortality rate for AH is close to 50%. We aimed to assess the efficacy of rifaximin in treating AH and its impact on inflammation and metabolism. Methods The trial was approved by relevant authorities (EudraCT no: 2014-02264-33, Scientific Ethics Committee, jr. no: H-1-2014-056). Primary outcomes were changes in metabolic and inflammatory markers. Secondary outcomes were portal hypertension, kidney and neurocognitive function. Results Thirty-two patients were randomized to standard medical therapy (SMT) or SMT plus rifaximin, allocation was concealed. Four patients in the SMT group and five patients in the SMT + rifaximin group died due to AH and liver failure. No adverse events related to the study medication were observed. We found no significant differences in amino acids or inflammation markers (IL-2, IL-6, IL-8, IL-10, TNF-α, interferon-γ) between the groups after 28 and 90 days. Conclusion Rifaximin does not alter inflammation or metabolism in patients with AH.

TidsskriftPLOS ONE
StatusUdgivet - mar. 2022

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© 2022 Kimer et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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