{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T18:57:23Z","timestamp":1754161043488,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T00:00:00Z","timestamp":1745971200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023453","name":"Norgine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Hepatic encephalopathy is a frequent complication of cirrhosis. Rifaximin\u2010\u03b1 has been included in guidelines for secondary prevention of hepatic encephalopathy, but there are few real\u2010world data on its efficacy and impact on healthcare utilization. In this study, we aimed to assess the effect of rifaximin\u2010\u03b1 on healthcare utilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We conducted a cohort analysis in patients from seven hospitals in the Netherlands, who received rifaximin\u2010\u03b1 as secondary prophylaxis for hepatic encephalopathy. Data were compared 6\u00a0months before and 6\u00a0months after the prescription of rifaximin\u2010\u03b1. The primary endpoint was the effect of rifaximin\u2010\u03b1 on healthcare utilization. Secondary endpoint was the effect of rifaximin\u2010\u03b1 on healthcare costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 126 patients (65% male; median age 68) with a median Model for End\u2010stage Liver Disease score of 15. The mean number of hepatic encephalopathy episodes after starting rifaximin\u2010\u03b1 was lower than before starting rifaximin\u2010\u03b1 (0.9 vs. 2.2; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Mean healthcare utilization decreased from 6.1 contacts in the 6\u00a0months before rifaximin\u2010\u03b1 to 3.3 contacts in the 6\u00a0months after starting rifaximin\u2010\u03b1 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The mean number of hospital admissions decreased from 1.7 admissions per patient to 1.0 admissions after starting rifaximin\u2010\u03b1 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). The mean number of outpatient visits also decreased after starting rifaximin\u2010\u03b1 (2.4 visits per patient to 1.7; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.001). Annual costs per patient before starting rifaximin\u2010\u03b1 were \u20ac13,320. This was similar to the costs after rifaximin\u2010\u03b1 was prescribed (\u20ac13,120).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Rifaximin\u2010\u03b1 significantly reduced the number of episodes of hepatic encephalopathy, the number of hospital admissions as well as the number of outpatient and emergency department visits, contributing to a reduction in healthcare utilization. There was no reduction in overall costs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ueg2.12767","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T06:56:31Z","timestamp":1745996191000},"page":"938-945","source":"Crossref","is-referenced-by-count":0,"title":["Rifaximin\u2010\u03b1 in Patients With Recurrent Episodes of Hepatic Encephalopathy Due to Cirrhosis Reduces Healthcare Utilization"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3299-0654","authenticated-orcid":false,"given":"Diederick J.","family":"van Doorn","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam Gastroenterology Endocrinology Metabolism Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsi. M. A.","family":"van Eekhout","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam Gastroenterology Endocrinology Metabolism Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8472-8549","authenticated-orcid":false,"given":"Koos","family":"de Wit","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam Gastroenterology Endocrinology Metabolism Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. C.","family":"Baak","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology OLVG  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7283-371X","authenticated-orcid":false,"given":"Michael","family":"Klemt\u2010Kropp","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Noordwest Ziekenhuisgroep  Alkmaar the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart J.","family":"Verwer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Spaarne Gasthuis  Hoofddorp the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip","family":"Friederich","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Meander Medisch Centrum  Amersfoort the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gijs J.","family":"de Bruin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tergooi MC  Hilversum the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xander G.","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Dijklander Ziekenhuis  Hoorn the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-3073","authenticated-orcid":false,"given":"Joost P. H.","family":"Drenth","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam Gastroenterology Endocrinology Metabolism Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2179-1385","authenticated-orcid":false,"given":"R. Bart","family":"Takkenberg","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Amsterdam Gastroenterology Endocrinology Metabolism Amsterdam UMC University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.05.042"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265\u2010018\u20101018\u2010z"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.06.001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40265\u2010018\u20101019\u2010y"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.02.015"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/642108"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010022\u201000366\u20106"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15491"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13435"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa0907893"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2013.219"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13111"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro\u20102016\u2010100792"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284819858256"},{"volume-title":"Methodologie van kostenonderzoek en referentieprijzen voor economische evaluaties in de gezondheidszorg","year":"2016","author":"Hakkaart\u2010van Roijen L.","key":"e_1_2_10_16_1"},{"key":"e_1_2_10_17_1","unstructured":"Institute for Medical Technology Assessment (iMTA) Costing Tool.1.6 ed.(2016) https:\/\/www.imta.nl\/tools\/."},{"volume-title":"Central Bureau for Statistics","year":"2020","key":"e_1_2_10_18_1"},{"volume-title":"Farmacotherapeutischkompas","year":"2015","key":"e_1_2_10_19_1"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/13696998.2021.1983291"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro\u20102022\u2010102221"}],"container-title":["United European Gastroenterology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ueg2.12767","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T10:40:25Z","timestamp":1753699225000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ueg2.12767"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,30]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1002\/ueg2.12767"],"URL":"https:\/\/doi.org\/10.1002\/ueg2.12767","archive":["Portico"],"relation":{},"ISSN":["2050-6406","2050-6414"],"issn-type":[{"type":"print","value":"2050-6406"},{"type":"electronic","value":"2050-6414"}],"subject":[],"published":{"date-parts":[[2025,4,30]]}}}