Arun Jesudian, MD: Gaps in Treatment for Overt Hepatic Encephalopathy

Patients with overt hepatic encephalopathy (OHE) who are treated with rifaximin upon discharge from the hospital are less likely to experience a 30-day OHE-related rehospitalization compared to patients who were not treated with rifaximin.

In data presented during the 2023 Digestive Disease Week (DDW) in Chicago, a team of investigators led by Arun Jesudian, MD, a transplant hepatologist NewYork-Presbyterian Hospital/Weill Cornell Medical College, found that there is also a reduction in medical costs that offset the increased pharmacy costs in the patients who were treated with rifaximin, going as far as saying that rifaximin is cost neutral.

The results of the study show that patients with OHE who were hospitalized and treated with rifaximin had an average length of stay of 10,8 days an average cost of $48,225. This was compared to 8 days and $29,108 for the cohort of patients not treated with rifaximin.

However, on the other hand, the 30-day risk of OHE-related rehospitalization was 6.8% in the rifaximin group, compared to 10.5% in the group not treated with rifaximin (adjusted odds ratio (aOR), 0.56; P <0.01).

In an interview with HCPLive®, Jesudian explained that in patients with OHE there is often a treatment gap following discharge that leads to worse outcomes in the short-term.

“There are multiple contributors to why a patient might not be taking rifaximin after their hospitalization,” Jesudian said. “Part of that is that the provider would need to prescribe it. Not all providers are aware of how complaining the data are and what the guidelines are.”