Rifaximin-αuse is associated with improved muscle mass in patients with cirrhosis  

作　　者：Thomas Worland Penelope Hey Darren Wong Ross Apostolov Roseanne Kimberley Chan Marie Sinclair Paul Gow 

机构地区：[1]Department of Gastroenterology,Monash Health,Clayton 3168,Victoria,Australia [2]Liver Transplant Unit,Austin Health,Heidelberg 3084,Victoria,Australia [3]Department of Medicine,University of Melbourne,Melbourne 3000,Victoria,Australia [4]Department of Gastroenterology,Austin Health,Heidelberg 3084,Victoria,Australia

出　　处：《World Journal of Hepatology》2025年第4期43-52,共10页世界肝病学杂志(英文)

基　　金：Supported by Norgine,the marketing authorization holder of rifaximin-α(Xifaxan©).

摘　　要：BACKGROUND Sarcopaenia is associated with a two-fold higher mortality rate in patients with cirrhosis independent of liver disease severity.Few treatments for cirrhosis related sarcopaenia exist beyond optimal nutritional management.AIM To assess if rifaximin-α,a minimally absorbed antimicrobial used to manage hepatic encephalopathy(HE),may improve sarcopaenia in cirrhosis through its ammonia lowering and anti-inflammatory properties.METHODS This single-centre retrospective cohort study of patients with prior HE compared patients treated with lactulose alone to those on combination therapy with rifaximin-α.The primary outcome was a change in skeletal muscle area(SMA)as measured by computed tomography over two time points.Secondary outcomes included episodes of spontaneous bacterial peritonitis,variceal bleeding,and gastrointestinal Clostridium difficile infection.RESULTS Of the 142 patients included,63 were on rifaximin-α[35%female,median age 57(51,62)],and 79 were on lactulose without rifaximin-α[20%female,median age 55(51,60)].Univariate analysis for SMA found that male sex(P<0.001),hepatocellular carcinoma presence(P=0.024),and greater baseline body mass index(P=0.001)were associated with improvement of SMA.Multivariate analysis that adjusted for baseline SMA was performed and found only use of rifaximin-α(P=0.029)to be associated with improvement of SMA.CONCLUSION This study demonstrates a significant independent association between rifaximin-αtherapy and muscle mass in patients with cirrhosis and HE.Prospective studies of rifaximin-αtherapy examining its impact on sarcopenia are required to assess its potential therapeutic role in this cohort.

关 键 词：RIFAXIMIN ENCEPHALOPATHY CIRRHOSIS Liver transplantation Sarcopaeni 

分 类 号：R575.2[医药卫生—消化系统]