Rifaximin significantly improves bloating in IBS-D
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In a composite of three trials, rifaximin provided a durable and significant improvement in bloating in patients with diarrhea-predominant irritable bowel syndrome as compared with placebo, according to results presented at UEG Week.
“A significantly greater percentage of patients receiving rifaximin were durable bloating responders compared to placebo using again the greater than or equal to one-point or the greater than or equal to two-point responder definition,” Brian E. Lacy, MD, PhD, from the Mayo Clinic in Jacksonville, Florida, said during his presentation.
Lacy and colleagues identified 1,894 patients with IBS-D and randomly assigned them to rifaximin 550 mg three times daily (n = 952) or placebo for 2 weeks (n = 942) and then a 4-week treatment-free follow-up period to assess patient response. Patients answered a daily and weekly questionnaire on IBS-related bloating and relief from medication to determine their bloating severity during the first and second trial. During the third trial, bloating severity was assessed based on the patient response to questions on their bloating within 24 hours.
Investigators reported that at baseline both treatment groups had a weekly average bloating score of 3.4.
“A significantly greater percentage of patients receiving rifaximin were bloating responders vs. placebo when response was defined as either a [greater than or equal to one-point] decrease (47.8% vs. 38.6%; P < .0001) or a [greater than or equal to two-point] decrease (23.3% vs. 17.8%; P = .003) in weekly average bloating score for [2 weeks or more] of the first 4 weeks post-treatment,” Lacy said.
Lacy reported that compared with placebo, rifaximin had a better least-squares mean change from baseline to week 1 of treatment (P = .0497), week 2 of treatment (P = .002) and week 1 to week 10 after treatment (P ≤ .01). More patients who received rifaximin than placebo achieved durable bloating response for 1-point or more response (36.4% vs. 28.9%; P < .001) and 2-point or more responders (16.1% vs. 12.3%; P = .02).
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