NICE NG50: Cirrhosis in over 16s: assessment and management 1
“Hepatic encephalopathy is a major complication of cirrhosis.”
“Approximately 50% of people with cirrhosis will develop clinically apparent hepatic encephalopathy at some stage after diagnosis – the risk being around 5-25% within 5 years.”
“Hospital admissions are common and inpatient stays often prolonged. The presence of hepatic encephalopathy is associated with a significant increase in mortality; survival after the first episode is 42% at 1 year and 23% at 3 years.” 1
NICE TA337 guidance 2 for preventing episodes of overt hepatic encephaopathy with TARGAXAN® 550 (rifaximin-α)
Section 1.1 recommends rifaximin-α, within its marketing authorisation, as an option for reducing the recurrence of episodes of overt hepatic encephalopathy in people aged 18 years or older. 2
“Expert clinical opinion suggests that rifaximin-α is effective in reducing the recurrence of hepatic encephalopathy episodes and is well tolerated. Treatment with rifaximin-α may improve quality of life, prevent readmissions to hospital and reduce morbidity and carer burden.” 3
Evidence supporting HE management with rifaximin-α around the UK and Republic of Ireland:
SMC: Rifaximin-α (TARGAXAN®) is accepted for use within NHS Scotland. 4
NCPE Ireland: Product accepted but no formal appraisal required 5
DHSSPS: The Department of Health Social Services and Public Safety (DHSSPS) have endorsed NICE TA 337 in Northern Ireland. 6
AWMSG: Product meets exclusion criteria due to positive NICE appraisal. 7