Metabolic Brain Disease

, Volume 31, Issue 6, pp 1365–1367 | Cite as

Current state of knowledge of hepatic encephalopathy (Part V): clinical efficacy of L-ornithine-L-aspartate in the management of HE

Short Communication

Abstract

In cirrhotic patients with portosystemic encephalopathy, OA has confirmed its efficacy both in uncontrolled clinical trials and more recently in placebo-controlled double-blind studies in patients with manifest hepatic encephalopathy and hyperammonemia. OA improved performance in Psyhometric Tests as well as mental state gradation. The therapy had little side effects, increasing with higher intravenously administered dosages, and was well tolerated after oral and parenteral administration.

Keywords

Hepatic encephalopathy Artificial liver support L-Ornithine L-Aspartate: treatment of hepatic encephalopathy Hyperammonemia 

Notes

Acknowledgment

The authors would like to express thanks to Prof. Kevin Mullen help and advice in the production of this manuscript.

References

  1. Abdo-Francis JM, Pérez-Hernández JL, Hinojosa-Ruiz A, Hernández-Vásquez JR (2010) Reduction in hospital stay with the use of L-ornithine-L-aspartate (LOLA) in patients with hepatic encephalopathy. Revista de Gastroenterología de México 2: 135−141Google Scholar
  2. Acharya SK, Bhatia V, Sreenivas V, Khanal S, Panda SK (2009) Efficacy of L-ornithine L-aspartate in acute liver failure: a double-blind, randomized, placebo-controlled study. Gastroenterology 136:2159–2168CrossRefPubMedGoogle Scholar
  3. Alvares-da-Silva MR, de Araujo A, Vicenzi JR, et al. (2013) Oral L-ornithine-L-aspartate in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled trial. Hepatol Res. doi: 10.1111/hepr.12235 [Epub ahead of print]PubMedGoogle Scholar
  4. Bai M, Yang Z, Qi X, Fan D, Han G (2013) L-ornithine-L-aspartate for hepatic encephalopathy in patients with cirrhosis: a meta-analysis of randomized controlled trials. J Gastroenterol Hepatol 28:783–792CrossRefPubMedGoogle Scholar
  5. Fleig WE, Kircheis G, Spengler U, Zeuzem ST, Görtelmeyer R, The German-Austrian-Swiss Multicenter Study Group (1999) Placebo-controlled, double-blind evaluation of L-ornithine–L-aspartate (LOLA) granules in patients with cirrhosis and subclinical (SHE) or mild overt hepatic encephalopathy (HE). J Hepatol 30 (Suppl. 1):65 (abstract)Google Scholar
  6. Kircheis G, Metz M, Frey S, Seiller E (1996) Correlation between pharmacokinetic aspects and clinical efficacy of L-ornithine–L-aspartate (OA): results of randomized, controlled clinical trials. J Hepatol 25:131 (abstract)Google Scholar
  7. Kircheis G, Nilius R, Berndt H, et al. (1997) Therapeutic efficacy of L-ornithine-L-aspartate infusion concentrate in patients with liver cirrhosis and hepatic encephalopathy: a placebo-controlled double-blind study. Hepatology 25:1351–1360CrossRefPubMedGoogle Scholar
  8. Kircheis G, Wettstein M, vom Dahl S, et al. (2002) Clinical efficacy of L-ornithine-L-aspartate in the management of hepatic encephalopathy. Metab Brain Dis 17:453–463CrossRefPubMedGoogle Scholar
  9. Leonhardt H, Bungert HJ (1972) Therapie der schweren Hyperammoniämie. Med Klin 67:1052–1056PubMedGoogle Scholar
  10. McPhail MJ, Leech R, Grover VP, Fitzpatrick JA, Dhanjal NS, Crossey MM, Pflugrad H, Saxby BK, Wesnes K, Dresner MA, Waldman AD, Thomas HC, Taylor-Robinson SD (2013) Modulation of neural activation following treatment of hepatic encephalopathy. Neurology 80:1041–1047CrossRefPubMedPubMedCentralGoogle Scholar
  11. Pérez Hernández JL (2011) Critical analysis of studies evaluating the efficacy of infusion of Lornithine- L-aspartate in clinical hepatic encephalopathy in patients with liver failure. Ann Hepatol 10(Suppl. 2):S66–S69PubMedGoogle Scholar
  12. Reynolds N, Downie S, Smith K, Kircheis G, Rennie MJ (1999) Treatment with L-ornithine–L-aspartate infusion restores muscle protein synthesis responsiveness to feeding in patients with cirrhosis. J Hepatol 30(Suppl.1):65 (abstract)Google Scholar
  13. Rose C, Michalak A, Rama Rao KV, Quack G, Kircheis G, Butterworth RF (1999) L-ornithine-L-aspartate lowers plasma and cerebrospinal fluid ammonia and prevents brain edema in rats with acute liver failure. Hepatology 30:636–640CrossRefPubMedGoogle Scholar
  14. Staedt U, Leweling H, Gladisch R, Kortsik C, Hagmüller E, Holm E (1993) Effects of ornithine aspartate on plasma ammmonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. J Hepatol 19:424–430CrossRefPubMedGoogle Scholar
  15. Stauch S, Kircheis G, Adler G, et al. (1998) Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double-blind study. J Hepatol 28:856–864CrossRefPubMedGoogle Scholar
  16. Tarao K, Ikeda T, Hayashi K, Sakurai A, Okada T, Ito T, Karube H, Nomoto T, Mizuno T, Shindo K (1990) Successful use of vancomycin hydrochloride in the treatment of lactulose resistant chronic hepatic encephalopathy. Gut 31:702–706CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.DüsseldorfGermany

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