{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T18:55:43Z","timestamp":1790016943796,"version":"4.0.1"},"reference-count":57,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,5,21]],"date-time":"2014-05-21T00:00:00Z","timestamp":1400630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Rifaximin is recommended for prevention of hepatic encephalopathy (<jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>). The effects of rifaximin on overt and minimal <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> are debated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To perform a systematic review and meta\u2010analysis of randomised controlled trials (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s) on rifaximin for <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed electronic and manual searches, gathered information from the U.S. Food and Drug Administration Home Page, and obtained unpublished information on trial design and outcome measures from authors and pharmaceutical companies. Meta\u2010analyses were performed and results presented as risk ratios (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) with 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) and the number needed to treat. Subgroup, sensitivity, regression and sequential analyses were performed to evaluate the risk of bias and sources of heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 19 <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>s with 1370 patients. Outcomes were recalculated based on unpublished information of 11 trials. Overall, rifaximin had a beneficial effect on secondary prevention of <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 1.32; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.06\u20131.65), but not in a sensitivity analysis on rifaximin after TIPSS (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 1.27; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.00\u20131.53). Rifaximin increased the proportion of patients who recovered from <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 0.59; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.46\u20130.76) and reduced mortality (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>: 0.68, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.48\u20130.97). The results were robust to adjustments for bias control. No small study effects were identified. The sequential analyses only confirmed the results of the analysis on <jats:styled-content style=\"fixed-case\">HE<\/jats:styled-content> recovery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Rifaximin has a beneficial effect on hepatic encephalopathy and may reduce mortality. The combined evidence suggests that rifaximin may be considered in the evidence\u2010based management of hepatic encephalopathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.12803","type":"journal-article","created":{"date-parts":[[2014,5,22]],"date-time":"2014-05-22T02:00:47Z","timestamp":1400724047000},"page":"123-132","source":"Crossref","is-referenced-by-count":185,"title":["Systematic review with meta\u2010analysis: the effects of rifaximin in hepatic encephalopathy"],"prefix":"10.1111","volume":"40","author":[{"given":"N.","family":"Kimer","sequence":"first","affiliation":[{"name":"Gastrounit Medical Division Copenhagen University Hospital Hvidovre Hvidovre Denmark"},{"name":"Department of Clinical Physiology and Nuclear Medicine Centre of Functional Imaging and Research Copenhagen University Hospital Hvidovre Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Krag","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Odense University Hospital University of Southern Denmark Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Centre of Functional Imaging and Research Copenhagen University Hospital Hvidovre Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Bendtsen","sequence":"additional","affiliation":[{"name":"Gastrounit Medical Division Copenhagen University Hospital Hvidovre Hvidovre Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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