Effects of long-term rifampicin administration in primary biliary cirrhosis
Open accessAbstract
The effects of rifampicin treatment (10 mg.kg-1.day-1) on pruritus and cholestasis were evaluated in 16 patients with primary biliary cirrhosis and pruritus followed up for 2-24 months. Assessment of pruritus severity, liver tests, aminopyrine breath test, and bile acids was done at 2 weeks and every 3 months after the beginning of the study. Two patients (12.5%) were withdrawn after 2 months of treatment because they had hepatitis caused by rifampicin. Four patients were withdrawn after 4 months because of liver transplantation (3 cases) and the development of leg edema associated with administration of rifampicin. The remaining 10 patients received therapy for 14.4 +/- 0.7 months and did not experience side effects. Pruritus improved in all patients and disappeared in 11 patients (79%) after 3 months of treatment. Moreover, all patients followed up for more than 1 year were free of pruritus. The alkaline phosphatase level decreased significantly, and the aminopyrine breath test results increased significantly after 2 weeks of treatment (P less than 0.001) and did not change thereafter. In the 9 patients treated for 15 months, alkaline phosphatase levels decreased to 63% of the basal levels and aminopyrine breath test results increased to 153% of baseline values. Transaminases, gamma-glutamyltransferase, and total bile salt levels decreased significantly after 2 weeks of treatment but returned to baseline after 3 months. No changes in bilirubin and cholesterol levels were observed. It is concluded that long-term rifampicin treatment is effective for relieving pruritus in primary biliary cirrhosis, but liver enzymes should be monitored to detect drug-induced hepatitis.
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Several prospective randomised placebo-controlled trials have shown rifampicin to be effective in the management of cholestatic pruritus.
“Several prospective randomised placebo-controlled trials have shown rifampicin to be effective in the management of cholestatic pruritus.182–185”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [185]
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- Authors
- Bachs, L., Parés, A., Elena, M., Piera, C., & Rodés, J.
- Affiliations
- Hospital Clínic de Barcelona (ES)
- ORCID
- Parés, Albert
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 1992-06
- Volume
- 102
- Issue
- 6
- Pages
- 2077-2080
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1219313770
- Cited by
- 235
- References
- 24
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 8 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 6 · 2019: 8 · 2018: 10 · 2017: 9 · 2016: 7 · 2015: 12 · 2014: 8 · 2013: 5 · 2012: 7
- FWCI
- 1.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Keywords
- rifampicin, primary biliary cirrhosis, pruritus, cholestasis, drug-induced hepatitis, aminopyrine breath test, alkaline phosphatase, bile acids, long-term drug therapy, adverse drug reactions
- MeSH terms
- Bile Acids and Salts, Cholestasis, Female, Humans, Liver, Liver Cirrhosis, Biliary, Middle Aged, Pruritus, Rifampin
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