Repeat Treatment With Rifaximin Is Safe and Effective in Patients With Diarrhea-Predominant Irritable Bowel Syndrome.

@article{Lembo2016RepeatTW,
  title={Repeat Treatment With Rifaximin Is Safe and Effective in Patients With Diarrhea-Predominant Irritable Bowel Syndrome.},
  author={Anthony J Lembo and Mark Pimentel and Satish S. C. Rao and Philip Schoenfeld and Brooks D. Cash and Leonard B. Weinstock and Craig Paterson and Enoch Bortey and William P. Forbes},
  journal={Gastroenterology},
  year={2016},
  volume={151 6},
  pages={
          1113-1121
        }
}
BACKGROUND & AIMS Few treatments have demonstrated efficacy and safety for diarrhea-predominant irritable bowel syndrome (IBS-D. [] Key MethodMETHODS The trial included adults with IBS-D, mean abdominal pain and bloating scores of 3 or more, and loose stool, located at 270 centers in the United States and Europe from February 2012 through June 2014.

Figures and Tables from this paper

Repeat Rifaximin for Irritable Bowel Syndrome: No Clinically Significant Changes in Stool Microbial Antibiotic Sensitivity
TLDR
Rifaximin exposure was not associated with long-term cross-resistance of Bacteroidaceae, Enterobacteriaceae, and Enterococcaceae to rifampin or nonrifamycin antibiotics tested.
Abdominal Pain Response to Rifaximin in Patients With Irritable Bowel Syndrome With Diarrhea
TLDR
Rifaximin is efficacious in improving abdominal pain in adults with IBS-D and should be considered as a first-line treatment for IBS with diarrhea, according to need.
Repeat treatment with rifaximin improves irritable bowel syndrome-related quality of life: a secondary analysis of a randomized, double-blind, placebo-controlled trial
TLDR
Open-label and blinded retreatment with a short course (2 weeks) of rifaximin improved IBS-QOL in patients with IBS, and the MCID in the overall IBS/QOL score was achieved by a significantly greater percentage of patients receiving double-blind rifaxin versus placebo.
Short-course Rifaximin therapy is effective and safe in patients with Diarrhea-Predominant Irritable Bowel Syndrome
TLDR
A short course (2 weeks) of rifaximin effectively and safely improved GI symptoms and QOL in Chinese patients with IBS-D, however, it did not eradicate SIBO completely, indicating that rifaxIMin might not be closely associated with LHBT normalization and that an additional therapeutic mechanism of r Halifaximin is urgently needed.
Rifaximin is associated with modest, transient decreases in multiple taxa in the gut microbiota of patients with diarrhoea-predominant irritable bowel syndrome
TLDR
The results suggest that rifaximin has a modest, largely transient effect across a broad range of stool microbes, and future research may determine whether the taxa affected by rifaxIMin are causally linked to IBS-D.
Rifaximin Re-treatment in Patients with Irritable Bowel Syndrome: Feels Like the First Time?
TLDR
The TARGET-3 has demonstrated that re-treatment is effective in IBS patients who initially respond to rifaximin and experience relapsing symptoms, which is a crucial issue when an antibiotic is used in clinical practice, as the development of mechanisms of resistance among bacteria may affect clinical efficacy.
Eluxadoline in irritable bowel syndrome with diarrhea: rationale, evidence and place in therapy
TLDR
Safety and tolerability data suggest that eluxadoline is generally well tolerated with the most common adverse events occurring in approximately 3–8% of patients and included nausea, constipation, and abdominal pain.
Lactulose Breath Testing as a Predictor of Response to Rifaximin in Patients With Irritable Bowel Syndrome With Diarrhea
TLDR
A positive baseline LBT result predicted a higher likelihood of response to rifaximin in IBS-D, suggesting a gut microbiome modulatory mechanism of action for rifaxIMin.
Mechanism of action and therapeutic benefit of rifaximin in patients with irritable bowel syndrome: a narrative review
TLDR
Current studies indicate that rifaximin induces only modest effects on the gut microbiota of patients with IBS-D, suggesting that the efficacy of rifaxin may involve other mechanisms, and further study is needed.
...
...

References

SHOWING 1-10 OF 39 REFERENCES
Rifaximin therapy for patients with irritable bowel syndrome without constipation.
TLDR
Among patients who had IBS without constipation, treatment with rifaximin for 2 weeks provided significant relief of IBS symptoms, bloating, abdominal pain, and loose or watery stools.
Eluxadoline for Irritable Bowel Syndrome with Diarrhea.
TLDR
Eluxadoline is a new therapeutic agent that reduced symptoms of IBS with diarrhea in men and women, with sustained efficacy over 6 months in patients who received the 100-mg dose twice daily.
The Effect of a Nonabsorbed Oral Antibiotic (Rifaximin) on the Symptoms of the Irritable Bowel Syndrome
TLDR
Whether the nonabsorbed antibiotic rifaximin is more effective than placebo in reducing symptoms in adults with IBS is determined.
A Randomized Double-Blind Placebo-Controlled Trial of Rifaximin in Patients with Abdominal Bloating and Flatulence
TLDR
Rifaximin is a safe and effective treatment for abdominal bloating and flatulence, including in IBS patients, and symptom improvement correlates with reduction in H2-breath excretion.
The Efficacy and Safety of Rifaximin for the Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis
TLDR
It was found that studies with older patients and more females demonstrated higher response rates, which was consistent regardless of treatment group, and rifaximin proved more effective than placebo for global symptoms and bloating in IBS patients.
Effects of Rifaximin Treatment and Retreatment in Nonconstipated IBS Subjects
TLDR
Retreatment with rifaximin for subjects with nonconstipated IBS in a real-world clinical practice was successful up to five times without decrease in duration or effect.
Safety and tolerability of rifaximin for the treatment of irritable bowel syndrome without constipation: a pooled analysis of randomised, double‐blind, placebo‐controlled trials
The efficacy of rifaximin, a nonsystemic, gut‐targeted antibiotic for reducing non–constipation‐predominant irritable bowel syndrome (non‐C IBS) symptoms, has been demonstrated in one phase 2b and
Evaluation of harm in the pharmacotherapy of irritable bowel syndrome.
Rifaximin: a nonabsorbable rifamycin antibiotic for use in nonsystemic gastrointestinal infections
TLDR
Rifaximin is effective in the treatment and prevention of travelers’ diarrhea due to Escherichia coli-predominant bacterial pathogens and may be useful in other enteric infectious diseases, including Clostridium difficile colitis, pediatric bacterial diarrhea and Helicobacter pylori gastritis.
Efficacy of Prebiotics, Probiotics, and Synbiotics in Irritable Bowel Syndrome and Chronic Idiopathic Constipation: Systematic Review and Meta-analysis
TLDR
Probiotics are effective treatments for IBS, although which individual species and strains are the most beneficial remains unclear, and the efficacy of all three therapies in CIC is also uncertain.
...
...