A systematic review of randomized, placebo-controlled trials found that rifaximin is as effective as other currently available therapies for irritable bowel syndrome.
After reviewing 13,700 citations, researchers at University of Michigan Health System analyzed five relevant studies and found rifaximin to be more effective than placebo for treating global IBS symptoms (OR=1.57; 95% CI=1.22, 2.01; therapeutic gain=9.8%; number needed to treat [NNT]=10.2), with mild heterogeneity (P=.25, I2=26%). Data for the secondary outcome of bloating were available for four studies. Rifaximin was significantly more likely to improve bloating than placebo (OR=1.55; 95% CI=1.23-1.96; therapeutic gain=9.9%; NNT=10.1), with no significant heterogeneity (P=.27, I=23%).
“Adverse effects were similar among patients receiving riflaximin or placebo in all studies,” the researchers said. “The modest therapeutic gain was similar to that yielded by other currently available therapies for IBS.”
The most common adverse effects were headache, upper respiratory infection, nausea, nasopharygitis, diarrhea and abdominal pain.
Disclosure: This research was supported by Division of Gastroenterology, University of Michigan Health System. William D. Checy is a consultant for Salix Pharmaceuticals.