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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 27, 2025; 17(9): 108951
Published online Sep 27, 2025. doi: 10.4254/wjh.v17.i9.108951
Published online Sep 27, 2025. doi: 10.4254/wjh.v17.i9.108951
Rifaximin and sarcopenia in cirrhosis: Commentary on a promising but complex relationship
Mohamed El-Kassas, Department of Endemic Medicine, Faculty of Medicine, Helwan Uni
Khalid AlNaamani, Department of Medicine, Division of Gastroenterology and Hepatology, The Medical City for Military and Security Services, Muscat 113, Oman
Author contributions: El-Kassas M conceptualized the idea, revised and edited the final manuscript; AlNaamani K drafted the manuscript; both authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest related to this work.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohamed El-Kassas, Professor, Department of Endemic Medicine, Faculty of Medicine, Helwan University, Ain Helwan, Cairo 11795, Egypt.
Received: April 27, 2025
Revised: June 13, 2025
Accepted: August 6, 2025
Published online: September 27, 2025
Processing time: 152 Days and 18.4 Hours
Revised: June 13, 2025
Accepted: August 6, 2025
Published online: September 27, 2025
Processing time: 152 Days and 18.4 Hours
Core Tip
Core Tip: The study by Worland et al adds valuable data suggesting that rifaximin-α may improve muscle mass in people with cirrhosis. We highlight plausible mechanisms beyond ammonia reduction, such as cytokine suppression and microbiota modulation. However, concerns regarding resistance and the need for prospective validation merit discussion.