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PWE-070 Rifaximin-Αlpha is associated with reductions in emergency department resource use in uk patients with hepatic encephalopathy: real world evidence from the impress study
  1. M Hudson1,
  2. P Di Maggio2,
  3. R Cipelli3,
  4. R Aspinall4
  1. 1Freeman Hospital, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne
  2. 2Norgine, Harefield
  3. 3pH Associates, Marlow
  4. 4Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK


Introduction In clinical trials rifaximin-α (RFX) has been shown to reduce recurrence of episodes of overt hepatic encephalopathy (HE) and HE-related hospitalisations. UK real world data confirmed reductions in hospital admissions and length of stay with RFX use, however data on use of emergency department (ED; A and E in UK) resources are still scarce. This study assessed the impact of RFX on utilisation of ED resources.

Method Patients from 11 UK hospitals who were prescribed RFX for HE between July-2008 and May-2014 were included in this retrospective observational study. Patient records were reviewed; details of demographic and clinical characteristics, and all-cause ED attendances and admissions were collected in the 6 and 12 months pre- and post-RFX initiation. The analysis included only patients who were alive at the end of the study periods.

Results Of the 145 patients included, 114 (79%) were alive at 6 months and 102 (70%) at 12 months post-RFX initiation. At RFX start, mean age was 61 years, 63% were male; 67% had alcohol-related liver disease; for patients with available MELD score (70%), the mean was 16; 78% were on lactulose. Use of ED resources in the 6 and 12 months pre- and post-RFX initiation is shown in Table 1. Six patients developed adverse events, none serious.

Conclusion In UK clinical practice, treatment with RFX for HE is well tolerated and associated with significant reductions in ED attendances, with or without admission, both within 6 and 12 months of RFX initiation.

Disclosure of Interest M. Hudson Conflict with: Norgine, Conflict with: Sponsored Lectures and advisory board member for Norgine, P. Di Maggio Conflict with: Norgine, R. Cipelli Conflict with: Norgine, Conflict with: pH Associates which was commissioned by Norgine to provide support with study design and management, data analysis and scientific editorial services, R. Aspinall Conflict with: Norgine, Conflict with: Sponsored Lectures and advisory board member for Norgine

Abstract PWE-070 Table 1

All-cause ED attendances, with and without admission, pre- and post-RFX initiation

  • A and E
  • Cirrhosis complication
  • emergency room
  • Hepatic Encepahlopathy
  • Hospitalisations
  • length of hospital stay
  • Resource use
  • rifaximin

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