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Related Experiment Videos

Rifaximin in non-alcoholic steatohepatitis: An open-label pilot study.

Jeremy F L Cobbold1,2, Stephen Atkinson1, Julian R Marchesi3,4

  • 1Department of Medicine, Imperial College London, London, UK.

Hepatology Research : the Official Journal of the Japan Society of Hepatology
|April 21, 2017
PubMed
Summary

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Rifaximin therapy did not improve liver inflammation, steatosis, or insulin sensitivity in non-alcoholic steatohepatitis (NASH) patients. The study found no beneficial effects of this gut microbiota modulation treatment for NASH.

Area of Science:

  • Gastroenterology and Hepatology
  • Microbiome Research
  • Metabolic Diseases

Background:

  • Gut microbial dysbiosis is linked to non-alcoholic steatohepatitis (NASH) pathogenesis.
  • Investigating gut microbiota modulation offers potential therapeutic strategies for NASH.

Purpose of the Study:

  • To assess the impact of rifaximin on hepatic inflammation, steatosis, and insulin sensitivity in NASH patients.
  • To evaluate downstream effects of gut microbiota modulation in NASH.

Main Methods:

  • Open-label pilot study involving biopsy-proven NASH patients with elevated aminotransferases.
  • Administered rifaximin 400 mg twice daily for 6 weeks, followed by a 6-week observation period.
  • Primary endpoint: change in alanine aminotransferase (ALT); Secondary endpoints: hepatic lipid content and insulin sensitivity via hyperinsulinemic-euglycemic clamp.
Keywords:
NAFLDantibiotichippurateinsulin resistancemicrobiotanon-alcoholic steatohepatitis

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Main Results:

  • No significant changes in ALT, peripheral glucose uptake, hepatic insulin sensitivity, or hepatic lipid content after 6 weeks of rifaximin.
  • Serum ALT levels increased after 12 weeks; homeostasis model assessment-estimated insulin resistance index significantly increased.
  • Reduced urinary hippurate observed during treatment, reverting post-cessation; no consistent changes in fecal microbiota abundance.

Conclusions:

  • Rifaximin therapy demonstrated no beneficial effects on key NASH markers in this patient cohort.
  • The study does not support the use of rifaximin for treating non-alcoholic steatohepatitis.