2009
DOI: 10.1590/s0004-28032009000300019
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A critical analysis of studies assessing L-ornithine-L-aspartate (LOLA) in hepatic encephalopathy treatment

Abstract: Although the trials have shown efficacy of LOLA in reducing hyperammonemia of hepatic encephalopathy, sufficient evidence of a significant beneficial effect of LOLA on patients with hepatic encephalopathy was not found. The studies performed in this area were small, with short follow-up periods and half of them showed low methodological quality.

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Cited by 17 publications
(6 citation statements)
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“…Finally, glutamate converts to glutamine, which detoxifies one ammonia molecule by glutamine synthetase [ 85 , 44 ]. The intravenous and oral administration of l -ornithine- l -aspartate successfully improved venous ammonia levels and cognitive abilities in HE patients [ 45 , 46 ]. However, a clinical trial in patients with acute liver failure did not show any improvement of the arterial ammonia levels compared to a standard treatment [ 86 ].…”
Section: Current Treatments Of Hyperammonemiamentioning
confidence: 99%
“…Finally, glutamate converts to glutamine, which detoxifies one ammonia molecule by glutamine synthetase [ 85 , 44 ]. The intravenous and oral administration of l -ornithine- l -aspartate successfully improved venous ammonia levels and cognitive abilities in HE patients [ 45 , 46 ]. However, a clinical trial in patients with acute liver failure did not show any improvement of the arterial ammonia levels compared to a standard treatment [ 86 ].…”
Section: Current Treatments Of Hyperammonemiamentioning
confidence: 99%
“…L-ornithine L-aspartate showed the highest reduction in serum ammonia in our results and the results were significant compared to the other arms, the serum ammonia is one of the core factors for hepatic encephalopathy pathogenesis. A previous study proved the effectiveness of L-ornithine L-aspartate in decreasing the ammonia levels in HE [62]. Although the combination between Lactulose and nitazoxanide is showing promising results in adverse event outcomes, more studies investigating this arm are still required with higher populations [62,63].…”
Section: Discussionmentioning
confidence: 99%
“…In a second critical analysis published two years later, searches were made of RCTs that were again published in indexed journals as well as in Medline, Cochrane and PubMed databases in which the efficacy of ivLOLA was assessed in patients with cirrhosis and HE. Six trials met inclusion criteria for a total of 623 patients 422 of which had cirrhosis while the remainder had acute liver failure [10].Trial quality was assessed using the Jadad Composite scale. [11] Venous ammonia concentrations decreased in the LOLA treatment group compared to placebo and these decreases were accompanied by significant improvements in the stage of HE assessed by West Haven criteria (Table 1).…”
Section: Efficacy Of Lola For the Treatment Of He In Cirrhosis: Earlymentioning
confidence: 99%