Rifaximin-α use is associated with improved muscle mass in patients with cirrhosis Article Swipe
Thomas Worland
,
Penelope Hey
,
Darren Wong
,
Ross Apostolov
,
Roseanne Kimberley Chan
,
Marie Sinclair
,
Paul Gow
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.4254/wjh.v17.i4.104056
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.4254/wjh.v17.i4.104056
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-α therapy and muscle mass in patients with cirrhosis and HE. Prospective studies of rifaximin-α therapy examining its impact on sarcopenia are required to assess its potential therapeutic role in this cohort.
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- Type
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- Language
- en
- Landing Page
- https://doi.org/10.4254/wjh.v17.i4.104056
- OA Status
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- Cited By
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All OpenAlex metadata
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https://openalex.org/W4409754036Canonical identifier for this work in OpenAlex
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https://doi.org/10.4254/wjh.v17.i4.104056Digital Object Identifier
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Rifaximin-α use is associated with improved muscle mass in patients with cirrhosisWork title
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articleOpenAlex work type
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enPrimary language
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2025Year of publication
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2025-04-25Full publication date if available
- Authors
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Thomas Worland, Penelope Hey, Darren Wong, Ross Apostolov, Roseanne Kimberley Chan, Marie Sinclair, Paul GowList of authors in order
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https://doi.org/10.4254/wjh.v17.i4.104056Publisher landing page
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diamondOpen access status per OpenAlex
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https://doi.org/10.4254/wjh.v17.i4.104056Direct OA link when available
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Medicine, Rifaximin, Cirrhosis, Muscle mass, Internal medicine, Sarcopenia, Gastroenterology, Intensive care medicine, Antibiotics, Biology, MicrobiologyTop concepts (fields/topics) attached by OpenAlex
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1Total citation count in OpenAlex
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10Other works algorithmically related by OpenAlex
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