Lv XY, Ding HG, Zheng JF, Fan CL, Li L. Rifaximin improves survival in cirrhotic patients with refractory ascites: A real-world study. World J Gastroenterol 2020; 26(2): 199-218 [PMID: 31988585 DOI: 10.3748/wjg.v26.i2.199]
Corresponding Author of This Article
Lei Li, MD, PhD, Associate Professor, Chief Physician, Department of Gastroenterology and Hepatology, Beijing You An Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai, Beijing 100069, China. m13699119545@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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World J Gastroenterol. Jan 14, 2020; 26(2): 199-218 Published online Jan 14, 2020. doi: 10.3748/wjg.v26.i2.199
Table 1 Baseline characteristics of patients, n (%)
Characteristic
Rifaximin group (n = 50)
Control group (n = 25)
P value
Age
54.60 ± 9.05
59.04 ± 10.01
0.057
Sex (male/female)
42/8
18/7
0.221
Etiology
HBV
14 (28)
9 (36)
0.479
HCV
3 (6)
0 (0)
0.546
Alcohol
22 (44)
7 (28)
0.180
HBV/alcohol
7 (14)
3 (12)
1.000
NASH
1 (2)
3 (12)
0.105
AIH
1 (2)
0 (0)
1.000
PBC
0 (0)
1 (4)
0.333
Cryptogenic
2 (4)
2 (8)
0.597
Child-Pugh grade (B/C)
21/29
16/9
0.072
MELD score
10 (6-13)
8 (6-10)
0.094
Furosemide (mg/d)
80 (40-80)
80 (40-80)
0.246
Spironolactone (mg/d)
160 (80-160)
160 (100-160)
0.315
Ascites (grade 1/2)
38/12
20/5
0.978
AKI
3 (6)
2 (8)
1.000
SBP
19 (38)
9 (36)
0.866
Hypertension
7 (14)
5 (20)
0.738
Diabetes mellitus
19 (38)
9 (36)
0.866
Biochemistry
ALT (U/L)
24.85 (13.75-42.58)
20.50 (16.40-34.95)
0.673
Alb (g/L)
28.40 ± 5.30
27.68 ± 3.79
0.526
TBil (μmol/L)
43.80 (25.88-93.78)
24.70 (18.75-55.55)
0.039
Scr (μmol/L)
70.20 (57.00-93.53)
64.20 (53.10-74.35)
0.256
Urea (mmol/L)
7.17 ± 4.70
6.68 ± 3.32
0.641
eGFR (mL/min 1.73 m2)
95.49 (76.17-114.81)
98.80 (86.80-109.37)
0.897
Coagulation
PTA (%)
54.00 (45.00-68.50)
64.00 (56.50-74.50)
0.030
INR
1.53 ± 0.39
1.37 ± 0.26
0.074
Routine blood test
WBC (109/L)
4.38 (3.41-6.04)
3.87 (3.26-6.78)
0.955
HGB (g/L)
101.22 ± 25.91
98.36 ± 23.03
0.642
PLT (109/L)
77 (54-102)
101 (56-172)
0.069
Table 2 Changes in clinical data of patients after treatment in the two groups
Rifaximin group (n = 50)
Control group (n = 25)
P value
d0
d15
mean delta
d0
d15
Mean delta
Weight (kg)
70.00 (60.00-78.75)
69.00 (58.00-74.00)
-3.30
62.00 (55.00-71.25)
59.5 (54.88-59.5)
-1.20
0.011
Cr (μmol/L)
70.20 (57.00-93.53)
78.25 (63.10-92.68)
11.82
9 (8.00-11.00)
73.0 (63.35-95.65)
13.54
0.777
Urea (mmol/L)
7.17±4.70
9.07±6.71
1.90
8 (5.50-10.00)
7.63±3.31
0.95
0.258
eGFR (mL/min 1.73 m2)
95.49 (76.17-114.81)
93.11 (71.92-108.00)
-5.20
98.80 (86.80-109.37)
92.0 (61.59-99.54)
-9.68
0.136
Child-Pugh score
10 (8.00-11.25)
9 (8.00-10.25)
-0.90
9 (8.00-11.00)
8 (7.50-10.50)
-0.76
0.666
MELD score
10 (6.00-13.00)
11.5 (6.75-15.25)
0.60
8 (5.50-10.00)
8 (6.50-10.00)
0.92
0.688
Table 3 Changes in the cytokine and lipopolysaccharide-binding protein levels in patients after treatment in the two groups
Rifaximin group (n = 26)
Control group (n = 13)
P value
d0
d15
d0
d15
IL-6 (pg/mL)
29.73 ± 101.82
8. 93 ± 6.13
27.05 ± 45.70
18.75 ± 39.11
0.644
IL-8 (pg/mL)
45.12 ± 91.71
117.47 ± 359.77
31.51 ± 90.82
42.92 ± 128.15
0.557
TNF-α (pg/mL)
3.62 ± 2.22
3.23 ± 1.31
2.79 ± 0.72
3.07 ± 0.83
0.356
MCP-1 (pg/mL)
93.32 ± 49.00
98.41 ± 61.21
86.71 ± 44.14
79.61 ± 39.87
0.481
IP-10 (pg/mL)
187.83 ± 180.08
150.35 ± 126.22
98.53 ± 57.02
228.25 ± 232.65
0.024
LBP (pg/mL)
6140682.77 ± 3478004.74
5828915.42 ± 3761441.65
5784964.46 ± 2841716.75
9792449.77 ± 8492517.57
0.071
Table 4 Changes in the abundance of beneficial bacteria after treatment
Classification
Rifaximin
Rifaximin + antibiotics
Before
After
P value
Before
After
P value
g_Lactobacillus
1.924
3.903
0.791
0.581
2.535
0.547
g_Bifidobacterium
12.567
21.949
0.301
5.036
9.524
0.641
s_Faecalibacterium_prausnitzii
10.448
8.193
0.910
6.590
3.206
0.148
Citation: Lv XY, Ding HG, Zheng JF, Fan CL, Li L. Rifaximin improves survival in cirrhotic patients with refractory ascites: A real-world study. World J Gastroenterol 2020; 26(2): 199-218