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RICE Trial: Rifaximin In Chronic Hepatic Encephalopathy - A Randomized, Controlled Trial

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00364689
Recruitment Status : Unknown
Verified April 2007 by University of Miami.
Recruitment status was:  Recruiting
First Posted : August 16, 2006
Last Update Posted : June 24, 2010
Bausch Health Americas, Inc.
Information provided by:
University of Miami

Brief Summary:

The purpose of this study is to compare the effectiveness of three different treatments for hepatic encephalopathy. These treatments are:

  • Group 1 - lactulose given with a rifaximin placebo (sugar pill)
  • Group 2 - lactulose given with rifaximin
  • Group 3 - rifaximin given alone

The goals of this study are to determine which treatment is most effective at (1) reducing admissions to hospital for hepatic encephalopathy and (2) improving mental function, during the study period.

Condition or disease Intervention/treatment Phase
Hepatic Encephalopathy Drug: Rifaximin alone, Rifaximin combined with Lactulose Phase 3

Detailed Description:


Hepatic encephalopathy (HE) is a reversible process resulting from advanced liver disease. It can range in severity from disturbed sleep patterns to profound coma and can be triggered by a number of common factors, including intestinal bleeding, infection, constipation, and dietary changes.

This study will compare two different medications, used alone or in combination, to prevent relapses of HE. Lactulose is a laxative (causes increased bowel movements) which has been widely used in the treatment of HE. However, it is not clear how effective it is for this purpose and is not always well tolerated. Rifaximin is an oral antibiotic which has been studied in the treatment of HE, including longer treatment courses but its role in the prevention of HE relapses is not clear. No studies to date have compared the use of lactulose to combination treatment with lactulose and rifaximin in the prevention of recurrent episodes of HE.

Study Overview:

This study is a single-center, randomized, controlled trial evaluating the efficacy and safety of rifaximin, given alone or in combination with lactulose, as compared to lactulose given alone, in subjects in remission from prior acute episodes of HE. This study seeks specifically to examine the role of combination treatment with rifaximin and lactulose, as compared to either treatment alone, in maintaining remission of HE.

Our study hypothesis is that rifaximin, given alone or in combination with lactulose, will reduce the number of hospital admissions for acute HE, and will improve overall mental function during the treatment period, relative to standard lactulose therapy.

This is a double-blinded study (for rifaximin only), which means that neither you nor your study doctor will know whether you are being treated with rifaximin or a placebo pill. You will, however, know whether you are receiving lactulose.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 75 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: RICE Trial: Rifaximin In Chronic Hepatic Encephalopathy - A Randomized, Controlled Trial
Study Start Date : August 2006

Resource links provided by the National Library of Medicine

Primary Outcome Measures :
  1. Number of hospitalizations for HE
  2. Changes in psychometric testing during study period

Secondary Outcome Measures :
  1. Number of hospitalization days for all causes
  2. Death or survival to liver transplantation
  3. Rate of adverse events with rifaximin treatment

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Cirrhosis of any cause
  • History of previous admission for acute HE within 1 year of screening

Exclusion Criteria:

  • History of allergy to lactulose or rifaximin.
  • Ongoing alcohol or drug dependence
  • Required use of sedatives or narcotics

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00364689

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Contact: Lennox J. Jeffers, MD 305-243-5787
Contact: Macy Ho, CRC 305-243-4648

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United States, Florida
Center For Liver Diseases - University of Miami Recruiting
Miami, Florida, United States, 33136
Contact: Macy Ho, CRC    305-243-4648   
Principal Investigator: Lennox J. Jeffers, MD         
Principal Investigator: Patrick J Amar, MD         
Sponsors and Collaborators
University of Miami
Bausch Health Americas, Inc.
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Principal Investigator: Lennox J. Jeffers, MD University of Miami
Principal Investigator: Patrick J Amar, MD University of Miami

Layout table for additonal information Identifier: NCT00364689     History of Changes
Other Study ID Numbers: EPROST #200060006
WIRB #20060298
First Posted: August 16, 2006    Key Record Dates
Last Update Posted: June 24, 2010
Last Verified: April 2007

Keywords provided by University of Miami:
Encephalopathy, Hepatic
Portosystemic Encephalopathy
Encephalopathy, Hepatocerebral
Encephalopathy, Portal-Systemic
Encephalopathy, Portosystemic
Hepatic Coma
Hepatic Stupor
Hepatocerebral Encephalopathy
Portal-Systemic Encephalopathy

Additional relevant MeSH terms:
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Hepatic Encephalopathy
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Liver Failure
Hepatic Insufficiency
Liver Diseases
Digestive System Diseases
Brain Diseases, Metabolic
Metabolic Diseases
Anti-Bacterial Agents
Anti-Infective Agents
Gastrointestinal Agents