TY - JOUR T1 - Real-world evidence of long-term survival and healthcare resource use in patients with hepatic encephalopathy receiving rifaximin-α treatment: a retrospective observational extension study with long-term follow-up (IMPRESS II) JF - Frontline Gastroenterology JO - Frontline Gastroenterol SP - 228 LP - 235 DO - 10.1136/flgastro-2022-102221 VL - 14 IS - 3 AU - Richard J Aspinall AU - Mark Hudson AU - Stephen D Ryder AU - Paul Richardson AU - Elizabeth Farrington AU - Mark Wright AU - Robert T Przemioslo AU - Francisco Perez AU - Melanie Kent AU - Roland Henrar AU - Joe Hickey AU - Debbie L Shawcross Y1 - 2023/05/01 UR - http://fg.bmj.com/content/14/3/228.abstract N2 - Objective To describe survival of patients with hepatic encephalopathy (HE), up to 5 years after initiation of rifaximin-α (RFX) treatment.Design/Method A retrospective, observational extension study within 9 National Health Service secondary/tertiary UK care centres. All patients had a clinical diagnosis of HE, were being treated with RFX and were included in the previous IMPRESS study which reported the 1-year experience. Demographics, clinical outcomes, selected cirrhosis-related complications, hospital admissions and attendances up to 5 years from RFX initiation were extracted from patient medical records and hospital electronic databases. The primary outcome measure was survival at 5 years post-initiation of RFX treatment.Results The study included 138 patients. The survival rate at 5 years post-initiation of RFX was 35% (95% CI 28.2% to 44.4%) overall and 36% (95% CI 26.1% to 45.4%) for patients with alcohol-related liver disease. Median survival from RFX initiation was 2.8 years (95% CI 2.0 to 3.8; n=136). Among 48 patients alive at 5 years, 54% remained on RFX treatment at the end of the observation period, 73% reported no cirrhosis-related complications and 22% (9/41) had received a liver transplant. Between 1 and 5 years post-initiation, total numbers of liver-related emergency department visits, inpatient admissions, intensive care unit admissions and outpatient visits were 84, 191, 3 and 709, respectively; the liver-related 30-day readmission rate was 37%.Conclusion Within UK clinical practice, RFX use in HE was associated with a 35% survival rate with high treatment adherence, 78% transplant-free survival rate, minimal healthcare resource and low rates of complications at 5 years post-initiation.Data are available on reasonable request. Data are available upon reasonable request. The data described in this article will be shared upon reasonable request from the corresponding author. ER -