The present study evaluated the efficacy of L-ornithine-L-aspartate (LOLA) as adjuvant therapy in cirrhotic patients with hepatic encephalopathy (HE).

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

The study found-

• Of 120 patients, 62 were males with a mean age of 57 ± 11 years.
• LOLA group (n=40, 66.7%) showed Higher Improvement in HE as compared to the placebo group (n=28, 46.7%).
• In patients with grade I or less encephalopathy, 35.3% and 20% of patients in the LOLA and placebo groups, respectively, showed improvement.
• In Patients with HE grade II and above, 79.1% and 55.6% cases in LOLA and placebo groups, respectively, showed improvement.
• On multivariate analysis, patients with HE of grade II and above, showed prothrombin time, creatinine level, and use of LOLA influences the outcome.
• Duration of hospitalization was 93.6 ± 25.7 hours and 135.2 ± 103.5 hours in LOLA and placebo groups, respectively.
• Both groups showed no side effects.

This study in cirrhotic patients with advanced hepatic encephalopathy shows that treatment with LOLA is safe and associated with relatively rapid improvement and shorter hospital stays.

Abid S, Jafri W, Mumtaz K, et al. Efficacy of L-ornithine-L-aspartate as adjuvant therapy in cirrhotic patients with hepatic encephalopathy. J Coll Physicians Surg Pak. 2011 Nov;21(11):666-71.