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Rifaximin in the treatment of Crohn’s disease. Results of the GRACE 02 study


Authors: D. Ďuričová 1;  M. Bortlík 1,3;  M. Lukáš 1,2
Authors‘ workplace: Klinické a výzkumné centrum pro střevní záněty ISCARE a. s. Lighthouse a 1. LF UK v Praze 1;  Ústav klinické biochemie a laboratorní diagnostiky 1. LF UK v Praze 2;  Interní klinika 1. LF UK v Praze 3
Published in: Gastroent Hepatol 2010; 64(3): 31-36
Category: IBD

Overview

It has been shown that the intestinal microbial system plays an important role in the induction and maintenance of intestinal inflammation in patients with Crohn‘s disease. Long-term antimicrobial therapy in patients with Crohn‘s disease is a part of therapeutical armamentarium mainly for septic or perianal complications. The GRACE 02 study was done to assess the rifaximin bioavailability, safety and efficacy in patients with mild to moderate ileal or colonic luminal Crohn’s disease. Rifaximin in the form of gastro-resistant granules was applied in two dosage regimens (800 mg vs. 1 600 mg daily). The study was performed at one centre and 24 patients were recruited. The results of the study proved that both dosage regimens of rifaximin gastro-resistant granules were well tolerated, safe, and had extremely low bio-availability. The clinical efficacy in terms of remission and response rates was higher in those who were treated with a higher dose of rifaximin compared to the lower dosage regimen (58 % vs. 33 %).

Key words:
Crohn‘s disease – ulcerative colitis – rifaximin – inflammatory bowel disease


Sources

1. Darfeuille-Michaud A, Boudeau J, Bulois P et al. High Prevalence of Adherent-Invasive Escherichia coli Associated With Ileal Mucosa n Crohn´s Disease. Gastroenterology 2004; 127(2): 412–421.

2. Swidsinski A, Ladhoff A, Pernthaler A et al. Mucosal Flora in Inflammatory Bowel Disease. Gastroenterology 2002; 122(1): 44–54.

3. Schultsz C, Van Den Berg FM, Ten Kate FW et al. The Intestinal Mucus Layer From Paients With Inflammatory Bowel Disease Harbours High Numbers of Bacteria Compared With Controls. Gastrenterology 1999; 117: 1089–1097.

4. Tamboli CP, Neut C, Desreumaux P et al. Dysbiosis in inlammatory bowel disease. Gut 2004; 53(1): 1–4.

5. D´Haens GR, Geboes K, Peeters M et al. Early Lesions of recurrent Crohn´s Disease Caused by Infusion of Intestinal Contents in Excluded Ileum. Gastroenterology 1998; 114: 262–267.

6. Wehkamp J, Harder J, Weichenthal M et al. NOD2 (CARD 15) mutations in Crohn´s disease are associated with diminished mucosal α-defensin expression. Gut 2004; 53: 1658–1664.

7. Wehkamp J, Schmid M, Stange EF. Defensins and other antimicrobial peptides in inflammatory bowel disease. Current Opinion in Gastroenterology 2007; 23(1): 370–378.

8. Perencevich M, Burakoff R. Use of Antibiotics in the Treatment of Inflammatory Bowel Disease. Inflamm Bowel Dis 2006; 12(7): 651–664.

9. Landers CJ, Cohavy O, Misra R. Selected Loss of Tolerance Evidenced by Crohn´s Disease-Associated Imune Responses to Auto and Microbial Antigens. Gastroenterology 2002; 123(3): 689–699.

10. Shanahan F. Probiotics in inflammatory bowel disease. Gut 2001; 48: 609.

11. Sutherland L, Singleton J, Sessions J et al. Double blind, placebo controlled trial of metronidazole in Crohn´s disease. Gut 1991; 32(9): 1071–1075.

12. Steinhart AH, Feagan BG, Wong CJ et al. Combined Budesonide and Antibiotic Therapy for Active Crohn´s Disease: A Randomized Controlled Trial. Gastroenterology 2002; 123: 33–40.

13. Rutgeerts P, Hiele M, Geboes K et al. Controlled Trial of Metronidazole Treatment for Prevention of Crohn´s Reccurence After Ileal Resection. Gastroenterology 1995; 108(6): 1617–1621.

14. Rutgeerts P, Van Assche G, Vermeire S et al. Ornidazole for Prophylaxis of postoperative Crohn´s Disease Recurrence. A Randomized, Double-Blind, Placebo-Controlled trial. Gastroenterology 2005; 128(4): 856–861.

15. Colombel JF, Lémann M, Cassagnou M et al. A Controlled trial comparing Ciprofloxacin With Mesalazine for the Treatment of Active Crohn´s Disease. Am J Gastroenterol 1999; 94(3): 674–678.

16. Turunen UM, Farkkila MA, Hakala K et al. Long-term Treatment of Ulcerative Colitis With Ciprofloxacin: A Prospective, Double-Blind, Placebo-Controlled Study. Gastroenterology 1998; 115: 1072–1078.

17. Sandborn JW, Pardi DS. Clinical Management of Pouchitis. Gastroenterology 2004; 127: 1809–1814.

18. Gionchetti P, Rizzelo F, Venturi A et al. Oral Bacteriotherapy as Maintenance Treatment in Patients With Chronic pouchitis: A Double-Blind, Placebo-Controlled Trial. Gastroenterology 2000; 119(2): 305–309.

19. Gionchetti P, Rizzelo F, Helwig U et al. Prophylaxis of Pouchitis Onset With Probiotic Therapy. A Double-Blind, Placebo-Controlled Trial. Gastroenterology 2003; 124(5): 1202–1209.

20. Mimura T, Rizzelo F, Helwig U et al. Once daily high dose probiotic therapy (VSL#^3) for maintaining remission in reccurent or refractory pouchitis. Gut 2004; 53(1): 108–114.

21. Prantera C, Lochs H, Campieri M et al. Antibiotic treatment of Crohn´s disease: results of a multicentre, double blind, randomized, placebo-controlled trial with rifaximin. Aliment Pharmacol Ther 2006; 23(8): 1117–1125.

22. Kornbluth A, Hunt M, George J. Efficacy and Safety in the Treatment of Mild-Moderate Crohn´s Disease: Results os An Open-Label pilot Study. Gastroenterology 2005; 128: A579.

23. Bosworth BP, Scherl EJ. A Novel Nonabsorbable Antibiotic (rifaximin) in the Treatment of Moderate To Severe Crohn´s Disease. Gastrenterology 2005; 128: A576.

24. Colombel JF, Sandborn WJ, Reinisch W et al: Infliximab, Azathioprine, or combination therapy for Crohn´s Disease. N Engl J Med 2010; 362(15): 1383–1395.

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