A Randomized Control Trial of Nitazoxanide Versus Rifaximin in Preventing the Recurrence of Hepatic Encephalopathy
DOI:
https://doi.org/10.70749/ijbr.v3i6.2868Keywords:
Nitazoxanide, Rifaximin, Hepatic Encephalopathy, Cirrhosis, Recurrence Prevention.Abstract
Hepatic encephalopathy (HE) is a serious complication of cirrhosis associated with recurrent hospitalizations and impaired quality of life. This randomized controlled trial compared the efficacy and safety of Nitazoxanide versus Rifaximin in preventing HE recurrence over six months. A total of 54 patients with recent episodes of overt HE were randomized equally to receive either Nitazoxanide or Rifaximin. The primary endpoint was the recurrence of HE, defined by CHESS score ≥1. Secondary outcomes included time to cure, disease-free interval, adverse events, and CHESS score trajectory. The recurrence rate was 40.74% in the Nitazoxanide group and 44.44% in the Rifaximin group (Risk Ratio = 0.917, 95% CI: 0.493–1.705, p = 1.000). Median time to cure was 5 days for Nitazoxanide and 6 days for Rifaximin (p = 0.318). Adverse events were mild and comparable across groups. Subgroup and sensitivity analyses confirmed the consistency of findings. Logistic regression showed no significant predictors of recurrence. Data integrity was high, with 98% completeness and minimal protocol deviation. Nitazoxanide demonstrated non-inferior efficacy and similar safety to Rifaximin, suggesting it may serve as a cost-effective alternative for secondary HE prophylaxis, especially in resource-limited settings.
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