{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T16:46:57Z","timestamp":1784566017670,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Purpose<\/jats:title><jats:p>Hepatic encephalopathy (HE) is a neuropsychiatric complication of liver cirrhosis. HE is associated with poor survival and detrimental effects on quality of life (QOL). The drawbacks of the long\u2010term use of rifaximin in HE necessitates searching for alternative therapies. In this context, our study aimed at evaluating the safety and efficacy of nitazoxanide (NTZ) as compared to rifaximin (RFX) in preventing the recurrence of HE and assessing its impact on QOL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>This prospective, randomized, double\u2010blind controlled study included 60 patients who were randomly assigned to receive either rifaximin 550\u00a0mg twice daily (group 1; n\u00a0=\u00a030) or nitazoxanide 500\u00a0mg twice daily (group 2; n\u00a0=\u00a030) for 24\u00a0weeks. During the study period, the patients' neurological symptoms, mental status, and performance were monitored. The serum levels of HE triggers (ammonia, TNF\u2010\u03b1, and octopamine) were assessed. The patients' health\u2010related quality of life was also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six months after treatment, patients on NTZ therapy showed a statistically significant improvement in CHESS score and mental status. NTZ provided 136\u00a0days of remission vs 67\u00a0days of remission for patients on RFX (<jats:italic>P<\/jats:italic><jats:sub>1<\/jats:sub>\u00a0=\u00a0.0001) and significant reduction in Child score (<jats:italic>P<\/jats:italic><jats:sub>1<\/jats:sub>\u00a0=\u00a0.018). Additionally, NTZ showed a statistically significant decrease in serum ammonia, TNF\u2010\u03b1, and octopamine levels as compared to rifaximin. Regarding QOL, NTZ group showed an improvement in total Chronic Liver Disease Questionnaire (CLDQ) score. Both groups experienced minor controllable side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nitazoxanide may represent a suitable and safe alternative therapy to rifaximin in preventing the recurrence of hepatic encephalopathy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.947","type":"journal-article","created":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T07:34:13Z","timestamp":1616744053000},"page":"812-824","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Nitazoxanide versus rifaximin in preventing the recurrence of hepatic encephalopathy: A randomized double\u2010blind controlled trial"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5824-5236","authenticated-orcid":false,"given":"Khadija A. 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