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TOPLINE:

The use of rifaximin-alpha as a secondary prophylactic agent in patients with cirrhosis and hepatic encephalopathy led to a significant reduction in healthcare utilisation, including fewer hospital admissions and outpatient visits, with fewer episodes of hepatic encephalopathy and without any notable changes in annual healthcare costs.

METHODOLOGY:

• Researchers conducted a cohort analysis using data from electronic medical records (March 2010 to May 2023) across seven hospitals in the Netherlands to investigate the effect of rifaximin-alpha on healthcare utilisation.
• They included 126 adult patients with confirmed cirrhosis and a documented history of hepatic encephalopathy (median age, 68 years; 65% men) who received rifaximin-alpha as secondary prophylaxis for hepatic encephalopathy for at least 6 months.
• Data collection encompassed demographic information, clinical findings, and healthcare utilisation metrics.
• Healthcare utilisation was defined as the use of hospital services such as the number of admissions and length of stay, number of emergency department visits, and outpatient and daycare visits.
• A comparison was performed between 6 months before and 6 months after the prescription of rifaximin-alpha. The post-prescription median follow-up duration was 57 months.

TAKEAWAY:

• The mean number of hepatic encephalopathy episodes was significantly lower after than before starting rifaximin-alpha (0.9 vs 2.2; P < .001).
• Healthcare utilisation decreased from 6.1 to 3.3 visits in the 6-month period after the initiation of rifaximin-alpha, and the mean number of hospital admissions decreased from 1.7 to 1.0 per patient (P < .001 for both).
• A similar decline was noted from before to after starting rifaximin-alpha in terms of the mean number of outpatient visits (P = .001) and emergency department visits without admission (P = .024).
• Total annual healthcare costs did not differ before and after the use of rifaximin-alpha.

IN PRACTICE:

"HE [hepatic encephalopathy] is a frequent and severe complication of cirrhosis and portal hypertension, reflected in a short TFS [transplant-free survival] and high use of healthcare. Prescribing rifaximin-α significantly reduces the number of episodes of HE and concurrent healthcare utilization in a real-world cohort," the authors wrote.

SOURCE:

This study, led by Diederick J. van Doorn, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. It was published online on April 30, 2025, in United European Gastroenterology Journal.

LIMITATIONS:

This study was conducted using only a single group, which limited the ability to determine causality. The retrospective nature may have compromised data accuracy and completeness due to the potential loss of follow-up information. Natural disease progression or modifications in clinical management were not adequately accounted for.

DISCLOSURES:

This study was financially supported by Norgine Pharma BV. One author reported receiving research support from the funding agency and speaker fees from other sources, and another author reported receiving consultant fees.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.