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Hepatic encephalopathy (HE) is a common complication of cirrhosis and is associated with substantial morbidity and mortality. Previous studies have shown that rifaximin (Xifaxan, a minimally absorbed antimicrobial agent with high concentration in the gastrointestinal tract) was superior to nonabsorbable disaccharides (the mainstay of therapy) and was as good or better than other antibiotics in treating patients with acute HE.
To evaluate the efficacy of using rifaximin concomitantly with a nonabsorbable disaccharide (lactulose) to maintain remission in HE patients, investigators conducted a randomized, double-blind, placebo-controlled trial involving cirrhotic patients who had experienced ≥2 episodes of documented HE in the previous 6 months…