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Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: A retrospective observational extension study with long-term follow-up (IMPRESS II)

Lookup NU author(s): Dr Mark Hudson

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).

Abstract

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.Objective: To describe survival of patients with hepatic encephalopathy (HE), up to 5 years after initiation of rifaximin-α (RFX) treatment. Design/Method: A retrospective, observational extension study within 9 National Health Service secondary/tertiary UK care centres. All patients had a clinical diagnosis of HE, were being treated with RFX and were included in the previous IMPRESS study which reported the 1-year experience. Demographics, clinical outcomes, selected cirrhosis-related complications, hospital admissions and attendances up to 5 years from RFX initiation were extracted from patient medical records and hospital electronic databases. The primary outcome measure was survival at 5 years post-initiation of RFX treatment. Results: The study included 138 patients. The survival rate at 5 years post-initiation of RFX was 35% (95% CI 28.2% to 44.4%) overall and 36% (95% CI 26.1% to 45.4%) for patients with alcohol-related liver disease. Median survival from RFX initiation was 2.8 years (95% CI 2.0 to 3.8; n=136). Among 48 patients alive at 5 years, 69% remained on RFX treatment at the end of the observation period, 74% reported no cirrhosis-related complications and 24% (9/37) had received a liver transplant. Between 1 and 5 years post-initiation, total numbers of liver-related emergency department visits, inpatient admissions, intensive care unit admissions and outpatient visits were 84, 194, 3 and 709, respectively; the liver-related 30-day readmission rate was 37%. Conclusion: Within UK clinical practice, RFX use in HE was associated with a 35% survival rate with high treatment adherence, 76% transplant-free survival rate, minimal healthcare resource and low rates of complications at 5 years post-initiation.

Publication metadata

Author(s): Aspinall RJ, Hudson M, Ryder SD, Richardson P, Farrington E, Wright M, Przemioslo RT, Perez F, Kent M, Henrar R, Hickey J, Shawcross DL

Publication type: Article

Publication status: Published

Journal: Frontline Gastroenterology

Year: 2023

Volume: 14

Issue: 3

Pages: 228-235

Online publication date: 10/11/2022

Acceptance date: 02/10/2022

Date deposited: 19/12/2022

ISSN (print): 2041-4137

ISSN (electronic): 2041-4145

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/flgastro-2022-102221

DOI: 10.1136/flgastro-2022-102221

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