Thématique :
- Foie
Originalité :
Solidité :
Très solide
Doit faire évoluer notre pratique :
Pas encore
Nom du veilleur :
Professeur Jean-Marie PERON
Coup de coeur :
  2016 Aug 12. pii: S0016-5085(16)34926-5  
  doi: 10.1053/j.gastro.2016.08.003  
  Repeat Treatment With Rifaximin is Safe and Effective in Patients With Diarrhea-predominant Irritable Bowel Syndrome.  
  Lembo A, Pimentel M, Rao SS, Schoenfeld P, Cash B, Weinstock LB, Paterson C, Bortey E, Forbes WP  


Few treatments have demonstrated efficacy and safety for diarrhea-predominant irritable bowel syndrome (IBS-D). A phase 3, randomized, double-blind, placebo-controlled trial was performed to evaluate the safety and efficacy of repeat treatment with the nonsystemic antibiotic rifaximin.


The trial included adults with IBS-D, mean abdominal pain and bloating scores of 3 or more, and loose stool, located at 270 centers in the United States and Europe from February 2012 through June 2014. Those responding to a 2 week course of open-label rifaximin 550 mg 3 times daily who then relapsed during an observation phase (up to 18 weeks) were randomly assigned to groups given repeat treatments of rifaximin 550 mg or placebo, 3 times daily for 2 weeks. The primary endpoint was percentage of responders after first repeat treatment, defined as a decrease in abdominal pain of 30% or more from baseline and a decrease in frequency of loose stools of 50% or more from baseline, for 2 or more weeks during a 4-week posttreatment period.


Of 1074 patients (44.1%) who responded to open-label rifaximin, 382 (35.6%) did not relapse, whereas 692 (64.4%) did; of these, 636 were randomly assigned to receive repeat treatment with rifaximin (n=328) or placebo (n=308). The percentage of responders was significantly greater with rifaximin than placebo (38.1% vs 31.5%, P=.03). The percentage of responders for abdominal pain (50.6% vs 42.2%, P=.018) was significantly greater with rifaximin than placebo, but not stool consistency (51.8% vs 50.0%, P=.42). Significant improvements were also noted for prevention of recurrence, durable response, and bowel movement urgency. Adverse event rates were low and similar between groups.


In a phase 3 study of patients with relapsing symptoms of IBS-D, repeat rifaximin treatment was efficacious and well tolerated.

Question posée
Traitement de la colopathie fonctionnelle par Rifaximine, une étude randomisée.
Question posée
La rifaximine n’est pas efficace que sur l’encéphalopathie hépatique !!!