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The adventof rifaximin, a poorly absorbed antibiotic, for recurrent hepatic encephalopathy (HE) represents a major therapeutical advance for a debilitating condition, the treatment of which had remained unchanged for more than 30 years. The development of HE represents decompensation of end-stage liver disease and is a marker of poor prognosis.1 Recurrent HE significantly reduces health-related quality of life (HRQOL) and is an indication for liver transplantation. A seminal randomised placebo-controlled study, which was published in 2010, demonstrated the efficacy of rifaximin in the secondary prevention of HE (60% reduction) as well as in the prevention of hospital admissions (50% reduction).2
Several studies have …
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