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

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified April 2007 by University of Miami.
Recruitment status was:  Recruiting
Valeant Pharmaceuticals International, Inc.
Information provided by:
University of Miami Identifier:
First received: August 15, 2006
Last updated: June 23, 2010
Last verified: April 2007

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 Intervention Phase
Hepatic Encephalopathy Drug: Rifaximin alone, Rifaximin combined with Lactulose Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: RICE Trial: Rifaximin In Chronic Hepatic Encephalopathy - A Randomized, Controlled Trial

Resource links provided by NLM:

Further study details as provided by University of Miami:

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

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

Estimated Enrollment: 75
Study Start Date: August 2006
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.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
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
  Contacts and Locations
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, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00364689

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

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
Valeant Pharmaceuticals International, Inc.
Principal Investigator: Lennox J. Jeffers, MD University of Miami
Principal Investigator: Patrick J Amar, MD University of Miami
  More Information Identifier: NCT00364689     History of Changes
Other Study ID Numbers: EPROST #200060006
WIRB #20060298
Study First Received: August 15, 2006
Last Updated: June 23, 2010

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:
Brain Diseases
Hepatic Encephalopathy
Central Nervous System Diseases
Nervous System Diseases
Liver Failure
Hepatic Insufficiency
Liver Diseases
Digestive System Diseases
Brain Diseases, Metabolic
Metabolic Diseases
Anti-Infective Agents
Gastrointestinal Agents
Nucleic Acid Synthesis Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Anti-Bacterial Agents processed this record on September 20, 2017