Critical analysis of studies evaluating the efficacy of infusion of L-ornithine L-aspartate in clinical hepatic encephalopathy in patients with liver failure

l‐ornithine‐l‐aspartate for hepatic encephalopathy in patients with cirrhosis: A meta‐analysis of randomized controlled trials

“…In the most recent two meta‐analyses, the authors did not show the subgroup analyses of OHE and MHE patients. Both of these two meta‐analyses pooled six RCTs, one of which was performed in patients with acute liver failure . Cirrhosis and acute liver failure have a different pathogenesis and prognosis.…”

“…Thus, only the RCTs with cirrhotic patients were pooled in our meta‐analysis. After these two recent meta‐analyses, two more RCTs that evaluated the effectiveness of LOLA on HE were published . In total, eight RCTs with 352 OHE and 294 MHE patients were included in this meta‐analysis.…”

“…Two meta‐analyses, which evaluated the pooled effectiveness of LOLA on HE, have been published in the last 2 years . These two meta‐analyses pooled studies with cirrhosis patients and studies with acute liver failure patients, and did not include the most recent two RCTs . An update of the meta‐analysis is needed to provide stronger and more general support of the management of HE by LOLA.…”