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L‐ornithine L‐aspartate in bouts of overt hepatic encephalopathy
Abstract
High‐quality data on the efficacy of L‐ornithine L‐aspartate (LOLA) in patients with cirrhosis and bouts of overt hepatic encephalopathy (OHE) are missing. We evaluated the efficacy of intravenous LOLA in the reversal of bouts of OHE in patients with cirrhosis. In this prospective, double‐blind, randomized, placebo‐controlled trial conducted at two tertiary care institutes in India, 370 patients with cirrhosis and bouts of OHE were screened. After exclusion, 193 (52.16%) patients were randomized to receive either intravenous infusions of LOLA (n = 98), 30 g daily, or placebo (n = 95) for 5 days. Standard of care treatment (including lactulose and ceftriaxone) was given in both groups. Randomization was done centrally (http://www.sealedenvelope.com/). All study personnel were blinded to the treatment assignment. Fasting venous ammonia levels were estimated daily from 0 to 5 days. Serum tumor necrosis factor‐alpha, interleukins, hemogram, and liver and renal function tests were performed at days 0 and 5. Primary outcome was mental state grade at day 5 of treatment. The grade of OHE was significantly lower in the LOLA group (compared to placebo) on days 1‐4 but not on day 5. The mean time taken for recovery was lower in the LOLA group compared to the placebo group (1.92 ± 0.93 versus 2.50 ± 1.03 days,P = 0.002; 95% confidence interval −0.852 to −0.202). Venous ammonia at day 5 and length of hospital stay were significantly lower in the LOLA group. No significant difference in interleukins was seen between the groups.Conclusion: In patients with bouts of OHE, intravenous LOLA (as an add‐on therapy to lactulose and ceftriaxone) significantly improves the grade of OHE over days 1‐4, but not on day 5, and decreases venous ammonia, time of recovery, and length of hospital stay. (H epatology 2018;67:700‐710).
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L-ornithine-L-aspartate may be beneficial for the treatment of hyperammonemia in critical cases or liver failure.
“L-ornithine-L-aspartate may be beneficial for the treatment of hyperammonemia in critical cases or liver failure [213][214][215][216][217].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [216]
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- 2014, Hepatic encephalopathy in chronic liver disease, Hepatology, 60, 715, 10.1002/hep.27210 · DOI
- 2008, Incidence and prevalence of cirrhosis in the United Kingdom, 1992‐2001: a general population‐based study, J Hepatol, 49, 732, 10.1016/j.jhep.2008.05.023 · DOI
- 2011, Prognostic assessment in patients with hepatic encephalopathy, Dis Markers, 31, 171, 10.1155/2011/832031 · DOI
- 2014, Hepatic encephalopathy is associated with significantly increased mortality among patients awaiting liver transplantation, Liver Transpl, 20, 1454, 10.1002/lt.23981 · DOI
- 1987, Ammonia: key factor in the pathogenesis of hepatic encephalopathy, Neurochem Pathol, 6, 1, 10.1007/BF02833598 · DOI
- 2008, Pathogenetic mechanisms of hepatic encephalopathy, Gut, 57, 1156, 10.1136/gut.2007.122176 · DOI
- 1998, Oral L‐ornithine‐L‐aspartate therapy of chronic hepatic encephalopathy: results of a placebo‐controlled double‐blind study, J Hepatol, 28, 856, 10.1016/S0168-8278(98)80237-7 · DOI
- 2001, Bacterial translocation of enteric organisms in patients with cirrhosis, J Hepatol, 34, 32, 10.1016/S0168-8278(00)00013-1 · DOI
- 2011, Probiotics for patients with hepatic encephalopathy, Cochrane Database Syst Rev, CD008716
- 2004, Dopaminergic agonists for hepatic encephalopathy, Cochrane Database Syst Rev, CD003047
- 2004, Benzodiazepine receptor antagonists for hepatic encephalopathy, Cochrane Database Syst Rev, CD002798
- 2004, Nonabsorbable disaccharides for hepatic encephalopathy, Cochrane Database Syst Rev, CD003044
- 2016, Non‐absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis, Cochrane Database Syst Rev, CD003044
- 2014, Deciphering the spectrum of low‐grade hepatic encephalopathy in clinical practice., 146, 887
- 2013, The nutritional management of hepatic encephalopathy in patients with cirrhosis: International Society for Hepatic Encephalopathy and Nitrogen Metabolism Consensus, Hepatology, 58, 325, 10.1002/hep.26370 · DOI
- 2008, L‐Ornithine‐L‐aspartate infusion efficacy in hepatic encephalopathy, J Coll Physicians Surg Pak, 18, 684
- 2015, Neuro inflammation in hepatic encephalopathy: mechanistic aspects, J Clin Exp Hepatol, 5, S21
- 1997, Therapeutic efficacy of L‐ornithine‐L‐aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo‐controlled, double‐blind study, Hepatology, 25, 1351, 10.1002/hep.510250609 · DOI
- 2010, A double‐blind, randomized, placebo‐controlled trial of intravenous L‐ornithine‐L‐aspartate on postural control in patients with cirrhosis, Liver Int, 30, 574, 10.1111/j.1478-3231.2010.02213.x · DOI · Paper page
- 2015, Management of overt hepatic encephalopathy, J Clin Exp Hepatol, 5, S82
- 2011, Efficacy of L‐ornithine‐L‐aspartate as an adjuvant therapy in cirrhotic patients with hepatic encephalopathy, J Coll Physicians Surg Pak, 21, 666
- 2011, A randomized controlled trial comparing lactulose, probiotics, and L‐ornithine L‐aspartate in treatment of minimal hepatic encephalopathy, Eur J Gastroenterol Hepatol, 23, 725, 10.1097/MEG.0b013e32834696f5 · DOI
- 2006, Efficacy of oral L‐ornithine‐L‐aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Results of a randomized, lactulose‐controlled study, Ann Hepatol, 5, 281, 10.1016/S1665-2681(19)31989-1 · DOI
- 2009, L‐Ornithine‐L‐aspartate in the management of hepatic encephalopathy: a meta‐analysis, J Gastroenterol Hepatol, 24, 9, 10.1111/j.1440-1746.2008.05582.x · DOI
- 2013, L‐Ornithine‐L‐aspartate for hepatic encephalopathy in patients with cirrhosis: a meta‐analysis of randomized controlled trials, J Gastroenterol Hepatol, 28, 783, 10.1111/jgh.12142 · DOI
- 2015, Systematic review with network meta‐analysis: the comparative effectiveness and safety of interventions in patients with overt hepatic encephalopathy, Aliment Pharmacol Ther, 41, 624, 10.1111/apt.13122 · DOI
- 2016, Current state of knowledge of hepatic encephalopathy (part V): clinical efficacy of L‐ornithine‐L‐aspartate in the management of HE, Metab Brain Dis, 31, 1365, 10.1007/s11011-016-9912-0 · DOI
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Global burden of liver disease: 2023 update
Devarbhavi, H., Asrani, S. K., Arab, J. P., Nartey, Y. A., Pose, E., & Kamath, P. S. (2023) · Journal of Hepatology · doi:10.1016/j.jhep.2023.03.017 · Cited by 2,267
Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update
Mao, Y., Ma, S., Liu, C., Liu, X., Su, M., Li, D., Li, Y., Chen, G., Chen, J., Chen, J., et al. (2024) · Hepatology International · doi:10.1007/s12072-023-10633-7 · Cited by 62
Metadata
- Authors
- Sidhu, S. S., Sharma, B. C., Goyal, O., Kishore, H., & Kaur, N.
- Venue
- Hepatology
- Published
- 2017-12-27
- Volume
- 67
- Issue
- 2
- Pages
- 700-710
- ISSN
- 0270-9139
- 1527-3350
- Cited by
- 82
- References
- 0
- Language
- en
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