Abstract
Background: Diarrhea-predominant irritable bowel syndrome (IBS-D) impairs patient quality of life (QOL). Rifaximin is an oral, nonsystemic antibiotic indicated for IBS-D. The objective of this secondary analysis was to evaluate rifaximin retreatment on IBS-related QOL in patients with IBS-D. Methods: Patients received open-label rifaximin 550 mg three times daily for 2 weeks. Clinical responders [simultaneously meeting weekly response criteria for abdominal pain (3/430% improvement from baseline in mean weekly pain score) and stool consistency (3/450% decrease from baseline in number of days/week with Bristol Stool Scale (BSS) type 6 or 7 stools) during 3/42 of first 4 weeks posttreatment] who relapsed during an up to 18-week treatment-free observation phase were randomly assigned to receive two 2-week courses of double-blind rifaximin or placebo, separated by 10 weeks. A validated 34-item IBS-QOL questionnaire examined patient responses in 8 domains. Results: The 2579 patients receiving open-label rifaximin experienced a mean improvement from baseline in IBS-QOL overall score of 54.9%. Responders to open-label rifaximin (n = 1074 of 2438 evaluable; 44.1%) had significantly greater improvement from baseline in IBS-QOL overall and all eight subdomain scores, including dysphoria, food avoidance, interference with activity, body image, and sexual function versus nonresponders at 4 weeks posttreatment (n = 1364; p < 0.001 for all comparisons). A significantly greater percentage of responders to open-label rifaximin achieved the minimally clinically important difference (MCID; 3/414-point improvement from baseline) in the overall IBS-QOL score versus nonresponders [n = 561 (52.2%) versus n = 287 (21.0%); p < 0.0001]. Among 636 patients with IBS-D relapse, the MCID in the overall IBS-QOL score was achieved by a significantly greater percentage of patients receiving double-blind rifaximin versus placebo (38.6% versus 29.6%, respectively; p = 0.009). Conclusions: Open-label and blinded retreatment with a short course (2 weeks) of rifaximin improved IBS-QOL in patients with IBS-D [ClinicalTrials.gov identifier: NCT01543178].
| Original language | English (US) |
|---|---|
| Pages (from-to) | 689-699 |
| Number of pages | 11 |
| Journal | Therapeutic Advances in Gastroenterology |
| Volume | 10 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 1 2017 |
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Keywords
- diarrhea
- irritable bowel syndrome
- quality of life
ASJC Scopus subject areas
- Gastroenterology
Cite this
Repeat treatment with rifaximin improves irritable bowel syndrome-related quality of life : A secondary analysis of a randomized, double-blind, placebo-controlled trial. / Cash, Brooks D.; Pimentel, Mark; Rao, Satish Sanku Chander; Weinstock, Leonard; Chang, Lin; Heimanson, Zeev; Lembo, Anthony.
In: Therapeutic Advances in Gastroenterology, Vol. 10, No. 9, 01.09.2017, p. 689-699.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Repeat treatment with rifaximin improves irritable bowel syndrome-related quality of life
T2 - A secondary analysis of a randomized, double-blind, placebo-controlled trial
AU - Cash, Brooks D.
AU - Pimentel, Mark
AU - Rao, Satish Sanku Chander
AU - Weinstock, Leonard
AU - Chang, Lin
AU - Heimanson, Zeev
AU - Lembo, Anthony
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background: Diarrhea-predominant irritable bowel syndrome (IBS-D) impairs patient quality of life (QOL). Rifaximin is an oral, nonsystemic antibiotic indicated for IBS-D. The objective of this secondary analysis was to evaluate rifaximin retreatment on IBS-related QOL in patients with IBS-D. Methods: Patients received open-label rifaximin 550 mg three times daily for 2 weeks. Clinical responders [simultaneously meeting weekly response criteria for abdominal pain (3/430% improvement from baseline in mean weekly pain score) and stool consistency (3/450% decrease from baseline in number of days/week with Bristol Stool Scale (BSS) type 6 or 7 stools) during 3/42 of first 4 weeks posttreatment] who relapsed during an up to 18-week treatment-free observation phase were randomly assigned to receive two 2-week courses of double-blind rifaximin or placebo, separated by 10 weeks. A validated 34-item IBS-QOL questionnaire examined patient responses in 8 domains. Results: The 2579 patients receiving open-label rifaximin experienced a mean improvement from baseline in IBS-QOL overall score of 54.9%. Responders to open-label rifaximin (n = 1074 of 2438 evaluable; 44.1%) had significantly greater improvement from baseline in IBS-QOL overall and all eight subdomain scores, including dysphoria, food avoidance, interference with activity, body image, and sexual function versus nonresponders at 4 weeks posttreatment (n = 1364; p < 0.001 for all comparisons). A significantly greater percentage of responders to open-label rifaximin achieved the minimally clinically important difference (MCID; 3/414-point improvement from baseline) in the overall IBS-QOL score versus nonresponders [n = 561 (52.2%) versus n = 287 (21.0%); p < 0.0001]. Among 636 patients with IBS-D relapse, the MCID in the overall IBS-QOL score was achieved by a significantly greater percentage of patients receiving double-blind rifaximin versus placebo (38.6% versus 29.6%, respectively; p = 0.009). Conclusions: Open-label and blinded retreatment with a short course (2 weeks) of rifaximin improved IBS-QOL in patients with IBS-D [ClinicalTrials.gov identifier: NCT01543178].
AB - Background: Diarrhea-predominant irritable bowel syndrome (IBS-D) impairs patient quality of life (QOL). Rifaximin is an oral, nonsystemic antibiotic indicated for IBS-D. The objective of this secondary analysis was to evaluate rifaximin retreatment on IBS-related QOL in patients with IBS-D. Methods: Patients received open-label rifaximin 550 mg three times daily for 2 weeks. Clinical responders [simultaneously meeting weekly response criteria for abdominal pain (3/430% improvement from baseline in mean weekly pain score) and stool consistency (3/450% decrease from baseline in number of days/week with Bristol Stool Scale (BSS) type 6 or 7 stools) during 3/42 of first 4 weeks posttreatment] who relapsed during an up to 18-week treatment-free observation phase were randomly assigned to receive two 2-week courses of double-blind rifaximin or placebo, separated by 10 weeks. A validated 34-item IBS-QOL questionnaire examined patient responses in 8 domains. Results: The 2579 patients receiving open-label rifaximin experienced a mean improvement from baseline in IBS-QOL overall score of 54.9%. Responders to open-label rifaximin (n = 1074 of 2438 evaluable; 44.1%) had significantly greater improvement from baseline in IBS-QOL overall and all eight subdomain scores, including dysphoria, food avoidance, interference with activity, body image, and sexual function versus nonresponders at 4 weeks posttreatment (n = 1364; p < 0.001 for all comparisons). A significantly greater percentage of responders to open-label rifaximin achieved the minimally clinically important difference (MCID; 3/414-point improvement from baseline) in the overall IBS-QOL score versus nonresponders [n = 561 (52.2%) versus n = 287 (21.0%); p < 0.0001]. Among 636 patients with IBS-D relapse, the MCID in the overall IBS-QOL score was achieved by a significantly greater percentage of patients receiving double-blind rifaximin versus placebo (38.6% versus 29.6%, respectively; p = 0.009). Conclusions: Open-label and blinded retreatment with a short course (2 weeks) of rifaximin improved IBS-QOL in patients with IBS-D [ClinicalTrials.gov identifier: NCT01543178].
KW - diarrhea
KW - irritable bowel syndrome
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85029334047&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029334047&partnerID=8YFLogxK
U2 - 10.1177/1756283X17726087
DO - 10.1177/1756283X17726087
M3 - Article
AN - SCOPUS:85029334047
VL - 10
SP - 689
EP - 699
JO - Therapeutic Advances in Gastroenterology
JF - Therapeutic Advances in Gastroenterology
SN - 1756-283X
IS - 9
ER -