SHM Converge Scientific Abstract ePoster Gallery-Rifaximin Treatment for Hepatic Encephalopathy Reduces Number of Days With Emergency Department Services Versus Lactulose Alone: A Claims Database Analysis

Rifaximin Treatment for Hepatic Encephalopathy Reduces Number of Days With Emergency Department Services Versus Lactulose Alone: A Claims Database Analysis

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This claims database analysis examined whether rifaximin plus lactulose lowers emergency department (ED) use in adults with hepatic encephalopathy (HE) compared with lactulose alone. Using two large U.S. commercial databases (IBM MarketScan and Optum Clinformatics), researchers identified treatment episodes in patients aged 18–64 years with HE and at least 6 months of prior enrollment.<br /><br />A total of 7,675 patients were included from MarketScan and 3,530 from Optum. Across both databases, rifaximin episodes were more common than lactulose-only episodes and had higher adherence rates. After adjusting for baseline differences such as age, comorbidities, health plan, region, and prior procedures, rifaximin was associated with fewer days involving ED services.<br /><br />In the full episode analysis, ED service days were reduced by 19% in MarketScan (adjusted incidence rate ratio [IRR] 0.81; 95% CI 0.76–0.87) and by 11% in Optum (IRR 0.89; 95% CI 0.81–0.98) compared with lactulose alone. In the high-adherence subgroup (proportion of days covered ≥80%), the reduction was even larger: 25% in MarketScan (IRR 0.75; 95% CI 0.68–0.83) and 18% in Optum (IRR 0.82; 95% CI 0.73–0.93).<br /><br />Overall, the study suggests that rifaximin plus lactulose may reduce ED healthcare utilization in patients at risk for HE, with the greatest benefit seen when adherence is high.

Asset Subtitle

Rowe B. Brookfield

Meta Tag

Author List Annie Guérin, George J. Joseph, Maliha Ahmad, Michael L. Volk, Rebecca Burne, Rowe B. Brookfield, Sherry Shi, Zeev Heimanson

Category Research

Concept Hepatic Encephalopathy

Concept Cirrhosis

Concept Rifaximin

Concept Lactulose

Concept Adherence

Distinguished Non-Finalist

Presenter Organization Salix Pharmaceuticals

Presenting Author Rowe B. Brookfield

Track Outcomes Research

Keywords

rifaximin

lactulose

hepatic encephalopathy

emergency department

ED utilization

claims database

MarketScan

Optum Clinformatics

adherence

healthcare utilization

Hepatic Encephalopathy

Cirrhosis

Rifaximin

Lactulose

Adherence