NEJM paper shows preventative benefit of antibiotic for liver disease

By Lauren Hammit

Nathan Bass, MD, PhD

An international study published in the March 25 New England Journal of Medicine showed what researchers call a clinical breakthrough in one of the greatest unmet needs for patients with advanced liver disease.

The double-blind study, led by Nathan Bass, MD, PhD, professor of Medicine and Gastroenterology in the UCSF Liver Center, found that the antibiotic rifaximin significantly reduced the risk of an episode of hepatic encephalopathy over a six-month period. Hepatic encephalopathy is a dangerous and chronically debilitating complication of cirrhosis of the liver.

More than 5.5 million Americans suffer from hepatic cirrhosis, which can lead to hepatic encephalopathy without warning, rendering patients incapable of self-care and often leading to hospitalization. In 2004, more than 50,000 people were hospitalized with the condition in the United States, according to the paper.

“These results underscore the value and potential of rifaximin as a highly effective treatment for hepatic encephalopathy,” Bass said.

Rifaximin’s effectiveness has been well documented, according to the paper, but its efficacy for prevention of the disease had not been established. Bass said the therapy also showed a highly significant effect in protecting patients with a history of hepatic encephalopathy and increased the duration of remission over six months.

The corresponding author on the paper was William Forbes, PharmD, of Salix Pharmaceuticals, of Morrisville, NC, which also supported the study.

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