Efficacy of L-ornithine-L-aspartate as an adjuvant therapy in cirrhotic patients with hepatic encephalopathy.

Abstract

OBJECTIVE:

To evaluate the efficacy of L-ornithine-L-aspartate (LOLA) as an adjuvant therapy in cirrhotic patients with hepatic encephalopathy (HE).

STUDY DESIGN:

Randomized placebo controlled study.

PLACE AND DURATION OF STUDY:

The Aga Khan University Hospital, Karachi in the year 2003-2004.

METHODOLOGY:

Patients with HE were randomized to receive LOLA or placebo medicine as an adjuvant to treatment of HE. Number connection test-A (NCT-A), ammonia level, clinical grade of HE and duration of hospitalization were assessed.

RESULTS:

Out of 120 patients, there were 62 males with mean age of 57 ± 11 years. Improvement in HE was higher (n=40, 66.7%) in LOLA group as compared to the placebo group (n=28, 46.7%, p=0.027). In patients with grade I or less encephalopathy, improvement was seen in 6 (35.3%) and 3 (20%) patients in LOLA and placebo groups respectively (p=0.667). Patients with HE grade II and above showed improvement in 34 (79.1%) and 25 (55.6%) cases in LOLA and placebo group respectively (p=0.019). On multivariate analysis patients with HE of grade II and above showed prothrombin time, creatinine level and use of LOLA influencing the outcome. Duration of hospitalization was 93.6 ± 25.7 hours and 135.2 ± 103.5 hours in LOLA and placebo groups respectively (p=0.025). No side effects were observed in either groups.

CONCLUSION:

In cirrhotic patients with advanced hepatic encephalopathy treatment with LOLA was safe and associated with relatively rapid improvement and shorter hospital stay.

• Authors: Shahab Abid, Wasim Jafri, Khalid Mumtaz, Muhammad Islam, Zaigham Abbas, Hasnain Ali Shah, Saeed Hamid
• Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (J Coll Physicians Surg Pak) Vol. 21 Issue 11 Pg. 666-71 (Nov 2011) ISSN: 1681-7168 [Electronic] Pakistan
• PMID: 22078345 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Infective Agents
• Dipeptides
• Gastrointestinal Agents
• Metronidazole
• Lactulose
• Glucose
• ornithylaspartate

Topics

• Anti-Infective Agents (therapeutic use)
• Dipeptides (administration & dosage)
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Follow-Up Studies
• Gastrointestinal Agents (therapeutic use)
• Glucose (therapeutic use)
• Hepatic Encephalopathy (drug therapy, etiology)
• Humans
• Infusions, Intravenous
• Lactulose (therapeutic use)
• Length of Stay
• Liver Cirrhosis (complications, drug therapy)
• Male
• Metronidazole (therapeutic use)
• Middle Aged
• Prospective Studies
• Treatment Outcome