caa a22 4500 445795409 CHVBK 20180317145123.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1007/s10620-011-1719-6 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1719-6 Double-Blind Randomized Controlled Trial of Rifaximin for Persistent Symptoms in Patients with Celiac Disease [Elektronische Daten] [Matthew Chang, Maria Minaya, Jianfeng Cheng, Bradley Connor, Suzanne Lewis, Peter Green] Background: Small intestinal bacterial overgrowth (SIBO) is one cause of a poor response to a gluten-free diet (GFD) and persistent symptoms in celiac disease. Rifaximin has been reported to improve symptoms in non-controlled trials. Aims: To determine the effect of rifaximin on gastrointestinal symptoms and lactulose-hydrogen breath tests in patients with poorly responsive celiac disease. Methods: A single-center, double-blind, randomized, controlled trial of patients with biopsy-proven celiac disease and persistent gastrointestinal symptoms despite a GFD was conducted. Patients were randomized to placebo (n=25) or rifaximin (n=25) 1,200mg daily for 10days. They completed the Gastrointestinal Symptom Rating Scale (GSRS) and underwent lactulose-hydrogen breath tests at weeks 0, 2, and 12. An abnormal breath test was defined as: (1) a rise in hydrogen of ≥20 parts per million (ppm) within 100min, or (2) two peaks ≥20ppm over baseline. Results: GSRS scores were unaffected by treatment with rifaximin, regardless of baseline breath tests. In a multivariable regression model, the duration of patients' gastrointestinal symptoms significantly predicted their overall GSRS scores (estimate 0.029, p<0.006). According to criteria 1 and 2, respectively, SIBO was present in 55 and 8% of patients at baseline, intermittently present in 28 and 20% given placebo, and 28 and 12% given rifaximin. There was no difference in the prevalence of SIBO between placebo and treatment groups at weeks 2 and 12. Conclusions: Rifaximin does not improve patients' reporting of gastrointestinal symptoms and hydrogen breath tests do not reliably identify who will respond to antibiotic therapy. Springer Science+Business Media, LLC, 2011 Celiac disease nationallicence Small intestine nationallicence Clinical pharmacology nationallicence Diarrhea nationallicence Malabsorption nationallicence Microbiology nationallicence Symptom score or index nationallicence Chang Matthew Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut Minaya Maria Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut Cheng Jianfeng Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA aut Connor Bradley Department of Medicine, Weill Medical College of Cornell University, New York, NY, USA aut Lewis Suzanne Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut Green Peter Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 2939-2946 0163-2116 56:10<2939 2011 56 10620 https://doi.org/10.1007/s10620-011-1719-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1719-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chang Matthew Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut NATIONALLICENCE 700 1- Minaya Maria Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut NATIONALLICENCE 700 1- Cheng Jianfeng Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA aut NATIONALLICENCE 700 1- Connor Bradley Department of Medicine, Weill Medical College of Cornell University, New York, NY, USA aut NATIONALLICENCE 700 1- Lewis Suzanne Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut NATIONALLICENCE 700 1- Green Peter Department of Medicine, Columbia University College of Physicians and Surgeons, 180 Fort Washington Avenue, 10032, New York, NY, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/10(2011-10-01), 2939-2946 0163-2116 56:10<2939 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer