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Comparison of Rifaximin and Lactulose for the Treatment of Hepatic Encephalopathy: A Prospective Randomized Study

 Yong-Han Paik  ;  Kwan Sik Lee  ;  Kwang-Hyub Han  ;  Kun Hoon Song  ;  Myoung Hwan Kim  ;  Byung Soo Moon  ;  Sang Hoon Ahn  ;  Se Joon Lee  ;  Hyo Jin Park  ;  Dong Ki Lee  ;  Chae Yoon Chon  ;  Sang In Lee  ;  Young Myoung Moon 
 YONSEI MEDICAL JOURNAL, Vol.46(3) : 399-407, 2005 
Journal Title
Issue Date
Female ; Gastrointestinal Agents/administration & dosage* ; Gastrointestinal Agents/adverse effects ; Hepatic Encephalopathy/drug therapy* ; Humans ; Lactulose/administration & dosage* ; Lactulose/adverse effects ; Male ; Middle Aged ; Prospective Studies ; Rifamycins/administration & dosage* ; Rifamycins/adverse effects ; Rifaximin ; Treatment Outcome
Hepatic encephalopathy ; rifaximin ; lactulose ; liver cirrhosis
Rifaximin has been reported to be effective for the treatment of hepatic encephalopathy (HE) in Europe. However, it is unknown whether Rifaximin is effective for the treatment of HE in Koreans, therefore we conducted a open-label prospective randomized study to evaluate the efficacy of rifaximin versus lactulose in Korean patients. Fifty-four patients with liver cirrhosis and hepatic encephalopathy were enrolled. Thirty-two patients were randomized to receive rifaximin and 22 to receive lactulose both over a 7-day periods. Before and at the end of treatment, gradation of blood ammonia, flapping tremor, mental status, number connection test (NCT) were performed and estimation of HE indexes determined. Both rifaximin and lactulose were effective in the majority of patients (84.4% and 95.4%, respectively, p=0.315). Blood NH3, flapping tremor, mental status, and NCT was significantly improved by rifaximin and lactulose, and the posttreatment levels of these measures were similar for the rifaximin and lactulose-treated groups, as was the HE index (rifaximin group (10.0→4.2, p=0.000); lactulose group (11.3→5.0, p=0.000)). One patient treated with rifaximin complained of abdominal pain, which was easily controlled. There was no episode of renal function impairment in either treatment group. Rifaximin proved to be as safe and as effective as lactulose for the treatment of Korean patients with hepatic encephalopathy.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Hwan(김명환)
Moon, Byung Soo(문병수)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Paik, Yong Han(백용한)
Song, Kun Hoon(송건훈)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Lee, Dong Ki(이동기) ORCID logo https://orcid.org/0000-0002-0048-9112
Lee, Sang In(이상인)
Lee, Se Joon(이세준) ORCID logo https://orcid.org/0000-0002-2695-2670
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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