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NICE recommends treatment for brain condition caused by liver failure

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The National Institute for Health and Care Excellence has issued final draft guidance backing a treatment for preventing recurrent episodes of hepatic encephalopathy.

The drug rifaximin (Targaxan) is a treatment for reducing the recurrence of episodes of hepatic encephalopathy in adults.

The brain condition, caused by liver failure, occurs when people become confused, lose consciousness or, in more serious cases, fall into a coma.

It is thought to be caused by a build-up of toxic substances in the body that are normally removed by the liver.

“Rifaximin can prevent life-threatening episodes and improve people’s quality of life”

Carole Longson

Professor Carole Longson, director of NICE’s Centre for Health Technology Evaluation, said new evidence had become available, which allowed it to recommend rifaximin as a treatment option for hepatic encephalopathy.

“This serious brain condition has far-reaching effects on people with the condition and their families and carers. It can be serious, even fatal,” she said.

“People affected may have to go into hospital regularly. Rifaximin can prevent these life-threatening episodes and improve people’s quality of life,” she added.

Final guidance on the use of rifaximin is expected to be published in the spring. Until then, NHS bodies should make decisions locally on the funding of specific treatments.

Andrew Langford, chief executive, British Liver Trust, said the drug offered an “invaluable treatment” for people with hepatic encephalopathy and “significantly” improved quality of life.

“As a charity that works with many people affected by hepatic encephalopathy, the British Liver Trust is very pleased with NICE’s decision,” he said.

Rifaximin, manufactured by Norgine, is a semi-synthetic derivative of the antibiotic rifamycin.

It decreases intestinal production and absorption of ammonia, which is thought to be responsible for the neurocognitive symptoms of hepatic encephalopathy.

The drug is currently available as 550mg film-coated tablets and is administered orally at this dose twice daily.

According to NICE, the manufacturer estimated an average cost of £1689.65 for six months of treatment at a net price of £259.23 per 56-tablet pack (excluding VAT).

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