Efficacy and safety of low-dose rifampicin in patients with benign intrahepatic cholestasis

Background and aim: Some previous studies supported that rifampicin was an effective treatment for benign intrahepatic cholestasis. However, the efficacy and safety of rifampicin remain unclear. Therefore, this study aimed to evaluate its efficacy and safety on benign intrahepatic cholestasis. Methods: A retrospective, single-center, observational study was conducted on patients diagnosed with benign intrahepatic cholestasis between 2019 and 2021, who were administered 150 mg of rifampicin orally once a day. We collected and analyzed the data at baseline and post-treatment, including total bilirubin (TBIL), direct bilirubin (DBIL), total bile acid (TBA), gamma-glutamyl transferase (GGT), alkaline phosphatase, aspartate aminotransferase, and alanine aminotransferase levels. Statistical analysis was performed using appropriate tests. Results: A total of 17 rifampicin-treated patients were enrolled in the study from January 2019 to January 2021. Among them, 14 patients (82%) improved, with significantly decreased TBIL, DBIL, and TBA levels after 3 weeks of treatment (all P < 0.05), whereas the remaining 3 had no improvement. Moreover, GGT levels of the former were significantly lower than those of the latter (34 (12–227) U/L vs. 244 (76–293) U/L, P = 0.023) at baseline. No severe adverse effect was observed during treatment. Conclusions: Low-dose rifampicin (150 mg per day) was an effective and safe treatment for benign intrahepatic cholestasis. Low GGT level at baseline and a significant decrease of TBIL, DBIL, and TBA levels within the first 3 weeks of treatment may lead to the good curative effect.