Plain English Summary
Background and study aims
Hepatic encephalopathy (HE) is a nervous system-related mental disorder for which symptoms include level of consciousness, slowing down of thoughts and movements, deterioration of mental status, confusion, and, in severe forms, coma. HE is a common complication of chronic liver cirrhosis caused by abnormal levels of toxins that accumulate in the blood, which are normally excreted in a healthy liver. We are carrying out a clinical study to understand the effect of a drug called rifaximin in treating patients with HE and how rifaximin is used in the management of HE in routine UK clinical practice.
Who can participate?
Patients who have been diagnosed with HE and are not taking rifaximin and patients on rifaximin for at least 12 months before the start of the study.
What does the study involve?
Details of all recorded inpatient (including critical care) and A&E episodes will be obtained for all patients, for the full 12-month periods before and after starting on rifaximin, even if rifaximin was discontinued prior to 12 months.
What are the possible benefits and risks of participating?
There is no additional risk to patients from taking part in this study since it only involves a retrospective review by a researcher of their medical records and electronic hospital admissions data.
Where is the study run from?
The study is run from tsecondary/tertiary care centres in the follwoing areas of the UK: Belfast, Bristol, Cambridge, Dundee, Durham, Edinburgh, Glasgow, Kings, Liverpool, Newcastle, Nottingham, Portsmouth, Royal Free, Southampton, Truro.
When is the study starting and how long is it expected to run for?
It is expected that the data collection will start from August-December 2014 and results are expected to be analysed from March-April 2014.
Who is funding the study?
Norgine Ltd, UK.
Who is the main contact?
Mr Robert Dew, Management Consultant: RobertDew@phassociates.com
Dr Sharmila Kar, UK Medical Director: Skar@norgine.com
Dr Mark Hudson
High Heaton Newcastle upon Tyne
+44(0)191 233 6161
The impact of rifaximin on the NHS hospital resource use associated with the management of patients with hepatic encephalopathy (HE): a retrospective observational study
Clinical trial data have demonstrated the potential of rifaximin to reduce overt hepatic encephalopathy (HE) episodes and hospitalisations. There is therefore a need by physicians, commissioners and other healthcare professionals caring for people with HE to understand the impact of management with rifaximin on NHS resource use in real world clinical practice. Currently available data is from evaluations undertaken in single UK centres. The study also aims to describe the characteristics of patients currently being managed with rifaximin and the associated patient pathways. It is hoped that these data will provide valuable information for physicians and commissioners to assist decision making and facilitate effective service provision and patient management in the NHS both acutely and long-term.
West of Scotland, REC 3, 20/06/2014, ref. 14/WS/1017
Non-interventional multi-centre retrospective observational research study
Primary study design
Secondary study design
Patient information sheet
Not available in web format, please use the contact details below to request a patient information sheet
This study will involve a review of the secondary/tertiary care medical records and electronic hospital admissions data for patients with hepatic encephalopathy who have received rifaximin as part of normal clinical practice. Patients initiated on rifaximin will be identified by members of the routine care team from hospital pharmacy databases with 6 months pre- vs post-initiation of rifaximin (liver specific). Data is collected from medical records and will be recorded and collected for the period of 12 months pre- and post-initiation of rifaximin.
Primary outcome measures
Data collection for the 6 months pre- vs post-initiation of rifaximin (liver-specific), including number of hospital bed days per patient.
Secondary outcome measures
1. Comparison of resource use: 6 months pre- vs post-initiation of rifaximin (liver specific and all cause) mainly evaluating hospitalisation (and re-hospitalisation) rates and hospital length of stay including ITU/HDU admissions
2. Patients' demographics and disease-related characteristics
3. Patient pathway
4. Adverse drug reactions to rifaximin
Overall trial start date
Overall trial end date
Participant inclusion criteria
1. Patients with a clinical diagnosis of hepatic encephalopathy
2. Hepatic encephalopathy diagnosed prior to initiation of rifaximin
3. Patients initiated on rifaximin for hepatic encephalopathy at least 12 months prior to the date of data collection
4. Both female and male, no restriction of age
Target number of participants
Participant exclusion criteria
1. Patients receiving rifaximin where subsequent clinical diagnosis excludes hepatic encephalopathy
2. Patients initiated on rifaximin at hospitals not taking part in the study
3. Patients for whom hospital records are unavailable
Recruitment start date
Recruitment end date
Countries of recruitment
Trial participating centre
Norgine Ltd (UK)
c/o Dr Sharmila Kar
Medical Director UK & IE
+44(0)1895 826 600
Norgine Ltd (UK)
Funding Body Type
Funding Body Subtype
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Results - basic reporting