비흡수성 경구용 항생제 노르믹스 과민성 장 증후군 치료효과입증

<table id=cafe_editor_main_table_color bgColor='#ffffff' cellpadding=0 cellspacing=0 border=0 width=100%><tr><td id=cafe_editor_main_table class=text>비흡수성 경구용 항생제   Rifaximin(노르믹스)...   과민성 장 증후군(IBS) 치료 효과 입증    <img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2F6AA18112-95BA-4E01-8C6A-C1B517DA3F64.jpg" width="400" height="225" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 598px; height: 434px; ">  [그림] 과민성 장 증후군 (Irritable Bowel Syndrome, IBS)    소장 내에 정상 세균총이 과잉 증식하는 경우 과민성 장 증후군(IBS)이 유발된다는 사실이 알려지면서 항균 요법이 전세계적으로 시도되기 시작하였다.  최근 경구용 비흡수성 항생제인  Rifaximin의 2주 투약 요법으로 IBS의 증상이 개선되는 효과가 미국, 캐나다 연구 기관을 통하여 실시된 임상 결과 입증되었다.  이는 저명한 의학 전문지 NEJM 최신호(2011.01)를 통해 발표되었다.     Rifaximin 2주 투약    본 임상은 1,260명의 변비 없는 IBS 환자를 대상으로 실시되었다  이중 맹검 비교 임상 시험이며  동일하게 디자인 된 TARGET 1과 TARGET 2로 나뉘어 실시되었다.   2주 동안 Rifaximin 550mg을 하루 세번 투여한 후 10주 동안 증상 개선 효과를 관찰하였다. (총 12주 기간)  <table Table" border="1" cellspacing="0" cellpadding="0" width="665" style="border-bottom-width: medium; border-bottom-style: none; border-bottom-color: initial; border-left-width: medium; border-left-style: none; border-left-color: initial; width: 498.65pt; border-collapse: collapse; border-top-width: medium; border-top-style: none; border-top-color: initial; border-right-width: medium; border-right-style: none; border-right-color: initial; "><tbody><tr style="height: 12.7pt; "><td valign="top" width="665" colspan="3" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 498.65pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: black; border-top-width: 1pt; border-top-style: solid; border-right-color: windowtext; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">변비 없는 IBS 환자 1260명 대상 </td></tr><tr style="height: 25.45pt; "><td valign="top" width="269" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 202.1pt; padding-right: 5.4pt; height: 25.45pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: windowtext; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">분류<o:p style="font-size: 12pt; "><o:p style="font-size: 12pt; "> </td><td valign="top" width="205" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; padding-left: 5.4pt; width: 153.4pt; padding-right: 5.4pt; background-image: initial; background-attachment: initial; background-origin: initial; background-clip: initial; background-color: rgb(253, 233, 217); height: 25.45pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">TARGET 1<o:p style="font-size: 12pt; "> 623명<o:p style="font-size: 12pt; "></td><td valign="top" width="191" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; padding-left: 5.4pt; width: 143.15pt; padding-right: 5.4pt; background-image: initial; background-attachment: initial; background-origin: initial; background-clip: initial; background-color: rgb(253, 233, 217); height: 25.45pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: windowtext; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">TARGET 2<o:p style="font-size: 12pt; "> 637명<o:p style="font-size: 12pt; "></td></tr><tr style="height: 12.7pt; "><td valign="top" width="269" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 202.1pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">Rifaximin 투여<o:p style="font-size: 12pt; "> (550mg t.i.d. 2주) </td><td valign="top" width="205" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 153.4pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">309명<o:p style="font-size: 12pt; "></td><td valign="top" width="191" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 143.15pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">315명<o:p style="font-size: 12pt; "></td></tr><tr style="height: 12.7pt; "><td valign="top" width="269" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 202.1pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">위약 투여<o:p style="font-size: 12pt; "> </td><td valign="top" width="205" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 153.4pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">314명<o:p style="font-size: 12pt; "></td><td valign="top" width="191" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 143.15pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">320명<o:p style="font-size: 12pt; "></td></tr><tr style="height: 12.7pt; "><td valign="top" width="665" colspan="3" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 498.65pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">관찰 방법<o:p style="font-size: 12pt; "> </td></tr><tr style="height: 12.7pt; "><td valign="top" width="665" colspan="3" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 498.65pt; padding-right: 5.4pt; height: 12.7pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">1. 매주 IBS 전반적 증상 및 복부팽만감(주증상) 개선 효과를 확인 (방문 또는 전화 문의)<o:p style="font-size: 12pt; "> 2. 매일 자동응답시스템(IVR)을 통해 IBS 전반적 증상 및 세부 증상 설문 (복부팽만감, 복부 통증, 대변 농도 등)<o:p style="font-size: 12pt; "> </td></tr></tbody></table>   IBS 증상 개선에  Rifaximin  효과 입증   Rifaximin 2주 투약 후 IBS의 전반적 증상을 매주 평가한 결과, 아래 표에서와 같이 Rifaximin 투여군이 대조군보다 약 10% 이상 더 높게 개선 효과가 나타났다.  <table Table" border="1" cellspacing="0" cellpadding="0" width="627" style="border-bottom-width: medium; border-bottom-style: none; border-bottom-color: initial; border-left-width: medium; border-left-style: none; border-left-color: initial; width: 470.2pt; border-collapse: collapse; border-top-width: medium; border-top-style: none; border-top-color: initial; border-right-width: medium; border-right-style: none; border-right-color: initial; "><tbody><tr style="height: 35.2pt; "><td width="271" colspan="2" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 203.05pt; padding-right: 5.4pt; height: 35.2pt; border-top-color: black; border-top-width: 1pt; border-top-style: solid; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; "><o:p style="font-size: 12pt; "> </td><td width="245" colspan="2" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 183.4pt; padding-right: 5.4pt; height: 35.2pt; border-top-color: black; border-top-width: 1pt; border-top-style: solid; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">환자 %<o:p style="font-size: 12pt; "> (증상 개선)</td><td width="112" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: windowtext; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 83.75pt; padding-right: 5.4pt; height: 35.2pt; border-top-color: black; border-top-width: 1pt; border-top-style: solid; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">P value<o:p style="font-size: 12pt; "></td></tr><tr style="height: 34.5pt; "><td width="271" colspan="2" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 203.05pt; padding-right: 5.4pt; height: 34.5pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">IBS 전반적 증상<o:p style="font-size: 12pt; "> (매주 평가,<o:p style="font-size: 12pt; "> 투약 후 4주 관찰)</td><td width="113" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 84.65pt; padding-right: 5.4pt; height: 34.5pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: windowtext; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">Rifaximin<o:p style="font-size: 12pt; "></td><td width="132" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 98.75pt; padding-right: 5.4pt; height: 34.5pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">위약<o:p style="font-size: 12pt; "></td><td width="112" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 83.75pt; padding-right: 5.4pt; height: 34.5pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; "><o:p style="font-size: 12pt; "> </td></tr><tr style="height: 16.9pt; "><td rowspan="3" width="102" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 76.3pt; padding-right: 5.4pt; height: 16.9pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: windowtext; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">호전<o:p style="font-size: 12pt; "></td><td width="169" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 126.75pt; padding-right: 5.4pt; height: 16.9pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">TARGET 1<o:p style="font-size: 12pt; "> </td><td width="113" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 84.65pt; padding-right: 5.4pt; height: 16.9pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">40.8<o:p style="font-size: 12pt; "> </td><td width="132" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 98.75pt; padding-right: 5.4pt; height: 16.9pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">31.2<o:p style="font-size: 12pt; "> </td><td width="112" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 83.75pt; padding-right: 5.4pt; height: 16.9pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">0.01<o:p style="font-size: 12pt; "> </td></tr><tr style="height: 6.05pt; "><td width="169" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 126.75pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">TARGET 2<o:p style="font-size: 12pt; "> </td><td width="113" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 84.65pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">40.6<o:p style="font-size: 12pt; "> </td><td width="132" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 98.75pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">32.2<o:p style="font-size: 12pt; "> </td><td width="112" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 83.75pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">0.03<o:p style="font-size: 12pt; "> </td></tr><tr style="height: 6.05pt; "><td width="169" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 126.75pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">종합<o:p style="font-size: 12pt; "> </td><td width="113" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 84.65pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">40.7<o:p style="font-size: 12pt; "> </td><td width="132" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 98.75pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">31.7<o:p style="font-size: 12pt; "> </td><td width="112" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 83.75pt; padding-right: 5.4pt; height: 6.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; "><0.001<o:p style="font-size: 12pt; "> </td></tr></tbody></table>   또한 이러한 IBS 증상 개선 효과는 10주 동안 계속적으로 Rifaximin 투여군이 대조군보다 더 높게 유지되었다.    [아래 그래프 참조] <v:shapetype id="_x0000_t75" coordsize="21600,21600" o:preferrelative="t" o:spt="75" filled="f" stroked="f" path=" m@4@5 l@4@11@9@11@9@5 xe"><v:stroke joinstyle="miter"></v:stroke><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0 "></v:f><v:f eqn="sum @0 1 0 "></v:f><v:f eqn="sum 0 0 @1 "></v:f><v:f eqn="prod @2 1 2 "></v:f><v:f eqn="prod @3 21600 pixelWidth "></v:f><v:f eqn="prod @3 21600 pixelHeight "></v:f><v:f eqn="sum @0 0 1 "></v:f><v:f eqn="prod @6 1 2 "></v:f><v:f eqn="prod @7 21600 pixelWidth "></v:f><v:f eqn="sum @8 21600 0 "></v:f><v:f eqn="prod @7 21600 pixelHeight "></v:f><v:f eqn="sum @10 21600 0 "></v:f></v:formulas><v:path o:extrusionok="f" gradientshapeok="t" o:connecttype="rect"></v:path><o:lock v:ext="edit" aspectratio="t"></o:lock></v:shapetype><img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2F1C09618C-E2DB-4BE5-978C-05FA0745208C.bmp" width="400" height="245" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 484px; height: 314px; ">   복부팽만감 개선 효과   <img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2FC3272F86-5F61-4A62-818A-A21D9350FC75.jpg" width="300" height="199" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 400px; height: 337px; "> IBS 주요 증상인 복부 팽만감 역시 Rifaximin 투여군이 대조군보다 10% 더 높은 개선 효과를 나타내었다.      <table Table" border="1" cellspacing="0" cellpadding="0" width="668" style="border-bottom-width: medium; border-bottom-style: none; border-bottom-color: initial; border-left-width: medium; border-left-style: none; border-left-color: initial; width: 501.35pt; border-collapse: collapse; border-top-width: medium; border-top-style: none; border-top-color: initial; border-right-width: medium; border-right-style: none; border-right-color: initial; "><tbody><tr style="height: 61.3pt; "><td valign="top" width="289" colspan="2" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 216.6pt; padding-right: 5.4pt; height: 61.3pt; border-top-color: black; border-top-width: 1pt; border-top-style: solid; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; "> </td><td valign="top" width="261" colspan="2" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 195.45pt; padding-right: 5.4pt; height: 61.3pt; border-top-color: black; border-top-width: 1pt; border-top-style: solid; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">환자 % (증상 개선)</td><td valign="top" rowspan="2" width="119" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 89.3pt; padding-right: 5.4pt; height: 61.3pt; border-top-color: black; border-top-width: 1pt; border-top-style: solid; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">P value</td></tr><tr style="height: 30.05pt; "><td valign="top" width="289" colspan="2" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 216.6pt; padding-right: 5.4pt; height: 30.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">IBS 관련 복부팽만감 (매주 평가, 투약 후 4주 관찰) </td><td valign="top" width="122" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 91.3pt; padding-right: 5.4pt; height: 30.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">Rifaximin</td><td valign="top" width="139" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 104.15pt; padding-right: 5.4pt; height: 30.05pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">위약</td></tr><tr style="height: 31.3pt; "><td valign="top" rowspan="3" width="102" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: black; border-left-width: 1pt; border-left-style: solid; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 76.3pt; padding-right: 5.4pt; height: 31.3pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: windowtext; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">호전</td><td valign="top" width="187" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 140.3pt; padding-right: 5.4pt; height: 31.3pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">TARGET 1 </td><td valign="top" width="122" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 91.3pt; padding-right: 5.4pt; height: 31.3pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">39.5</td><td valign="top" width="139" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 104.15pt; padding-right: 5.4pt; height: 31.3pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">28.7</td><td valign="top" width="119" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 89.3pt; padding-right: 5.4pt; height: 31.3pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">0.005</td></tr><tr style="height: 10.75pt; "><td valign="top" width="187" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 140.3pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">TARGET 2 </td><td valign="top" width="122" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 91.3pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">41.0</td><td valign="top" width="139" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 104.15pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">31.9</td><td valign="top" width="119" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 89.3pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">0.02</td></tr><tr style="height: 10.75pt; "><td valign="top" width="187" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 140.3pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">종합 </td><td valign="top" width="122" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 91.3pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">40.2</td><td valign="top" width="139" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 104.15pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; ">30.3</td><td valign="top" width="119" style="font-family: 굴림; color: rgb(0, 0, 0); line-height: 18px; letter-spacing: 0px; word-break: break-all; border-bottom-color: black; border-bottom-width: 1pt; border-bottom-style: solid; border-left-color: rgb(236, 233, 216); border-left-width: initial; border-left-style: initial; padding-bottom: 0cm; background-color: transparent; padding-left: 5.4pt; width: 89.3pt; padding-right: 5.4pt; height: 10.75pt; border-top-color: rgb(236, 233, 216); border-top-width: initial; border-top-style: initial; border-right-color: black; border-right-width: 1pt; border-right-style: solid; padding-top: 0cm; "><0.001</td></tr></tbody></table>    <img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2F1225285D-B950-4FFA-9AAA-4DD11954E214.bmp" width="400" height="443" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 656px; height: 860px; "> [그림 A]  왼쪽) Rifaximin 및 대조약(Placebo) 투약 후 증상 개선 효과<o:p style="text-align: left; ">   오른쪽) Odds Ratio : 약물 투약 후 4주 관찰 기간  <o:p style="text-align: left; ">                    (1보다 클수록 Rifaximin이 더  효과적) <o:p style="text-align: left; "> <img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2F6F75E958-8849-4D1A-83AD-3B5F6431AF16.bmp" width="400" height="443" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 602px; height: 646px; "> [그림 B] Rifaximin 및 대조약(Placebo) 투약 후 총 10주 관찰 기간 동안                       Odds Ratio (1보다 클수록 Rifaximin이 더 효과적)     대조군과의 안전성에   차이는 없어   Rifaximin 투여군은 대조군과 비슷한 안전성을 나타내었으며 클로스트리디움 디피실리균(C. difficle)에 의한 설사 또는 허혈성 대장염은 나타나지 않았다.     IBS와 장내 세균   과민성 장 증후군(IBS)은 임상에서 흔히 볼 수 있는 질환 중의 하나로, 복부 통증, 복부 팽만감, 설사나 변비 등의 증상들이 반복되는 소화기계 이상 질환이다.   <img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2FD5F3FF3F-B86A-45DF-B96D-58113BE879B6.jpg" width="400" height="392" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 329px; height: 341px; ">   그러나 아직까지 IBS의 질환 병태가 명확하게 밝혀지지 않아 혁신적 치료 약물 개발에 한계가 있어 왔다.   그러나 대장의 질병으로 알려져온 IBS 환자중 30%는 소장에서 장내 세균총이 과잉 증식하면서 과잉의 가스를 발생하는 등 IBS 증상을 나타낸다는 사실이 인정되면서 2006년 경부터 IBS 치료에 있어 항균 요법이 전세계적으로 거론되기 시작하였다.   <img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2FD3D5D4F3-4FBD-495B-A4E8-CECD7AA452D8.jpg" width="389" height="248" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 472px; height: 312px; ">  실제적으로 Neomycin이나 Tetracycline과 같은 항생제가 IBS 증상을 개선시키는 효과를 나타내기는 하였으나  그 효과가 미비하고 전신 흡수에 따른 부작용으로 사용에 한계를 보였다.   경구용 비흡수성 항생제인 Rifaximin은 전신 흡수가 거의 없고 따라서 부작용이 없을뿐 아니라 내성을 거의 일으키지 않고  장내 세균 과잉 증식(SIBO)을 억제할 수 있음이 밝혀진 것이다.      <img src="https://img1.daumcdn.net/relay/cafe/original/?fname=http%3A%2F%2Fwww.hanall.co.kr%2FDOC_IMG%2Fimages%2F3355A604-1458-4B17-902C-82E9C536EEC9.bmp" width="400" height="286" style="border-top-width: 0px; border-right-width: 0px; border-bottom-width: 0px; border-left-width: 0px; border-top-style: none; border-right-style: none; border-bottom-style: none; border-left-style: none; border-color: initial; width: 400px; height: 286px; "><v:stroke joinstyle="miter"></v:stroke><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0"></v:f><v:f eqn="sum @0 1 0"></v:f><v:f eqn="sum 0 0 @1"></v:f><v:f eqn="prod @2 1 2"></v:f><v:f eqn="prod @3 21600 pixelWidth"></v:f><v:f eqn="prod @3 21600 pixelHeight"></v:f><v:f eqn="sum @0 0 1"></v:f><v:f eqn="prod @6 1 2"></v:f><v:f eqn="prod @7 21600 pixelWidth"></v:f><v:f eqn="sum @8 21600 0"></v:f><v:f eqn="prod @7 21600 pixelHeight"></v:f><v:f eqn="sum @10 21600 0"></v:f></v:formulas><v:path o:connecttype="rect" gradientshapeok="t" o:extrusionok="f"></v:path><o:lock v:ext="edit" aspectratio="t"></o:lock>  [그림] 비흡수성 소화기 전문 항생제 Rifaximin  Rifaximin은 미국 FDA에 승인되어 현재 15개국 이상 국가에서 처방되고 있는 제품이다. 한올바이오파마는 Alfa Wassermann 사와 기술 제휴를 통해, Rifaximin(노르믹스)을 국내 독점 공급 중이다.  [근거] Rifaximin Therapy for Patients with Irritable Bowel Syndrome without Constipation Mark Pimentel, M.D., Anthony Lembo, M.D., William D. Chey, M.D., Salam Zakko, M.D., Yehuda Ringel, M.D., Jing Yu, Ph.D., Shadreck M. Mareya, Ph.D., Audrey L. Shaw, Ph.D., Enoch Bortey, Ph.D., and William P. Forbes, Pharm.D. for the TARGET Study GroupN Engl J Med 2011; 364:22-32<a href="http://www.nejm.org/toc/nejm/364/1/" style="font-family: verdana; font-size: 11px; color: rgb(34, 34, 34); ">January 6, 2011</a> Tack, Jan, . (2011) Antibiotic Therapy for the Irritable Bowel Syndrome. New England Journal of Medicine 364:1, 81-82  </tr></td></table>