L-ornithine-L-aspartate infusion efficacy in hepatic encephalopathy.

Abstract

OBJECTIVE:

To determine the efficacy of L-ornithine-L-aspartate in treatment of hepatic encephalopathy.

STUDY DESIGN:

Randomized, placebo-controlled trial.

PLACE AND DURATION OF STUDY:

Department of Gastroenterology and Hepatology, Sheikh Zayed Hospital, Lahore, from February to August 2005.

METHODOLOGY:

Cirrhotic patients with hyperammonemia and overt hepatic encephalopathy were enrolled. Eighty patients were randomized to two treatment groups, L-ornithine-L-aspartate (20 g/d) or placebo, both dissolved in 250 mL of 5% dextrose water and infused intravenously for four hours a day for five consecutive days with 0.5 g/kg dietary protein intake at the end of daily treatment period. Outcome variables were postprandial blood ammonia and mental state grade. Adverse reactions and mortality were also determined.

RESULTS:

Both treatment groups were comparable regarding age, gender, etiology of cirrhosis, Child-Pugh class, mental state grade and blood ammonia at baseline. Although, improvement occurred in both groups, there was a greater improvement in L-ornithine-L-aspartate group with regard to both variables. Four patients in the placebo group and 2 in L-ornithine-L-aspartate group died.

CONCLUSION:

L-ornithine-L-aspartate infusions were found to be effective in cirrhotic patients with hepatic encephalopathy.

• Authors: Irfan Ahmad, Anwaar A Khan, Altaf Alam, Akif Dilshad, Arshad Kamal Butt, Farzana Shafqat, Kashif Malik, Shahid Sarwar
• Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP (J Coll Physicians Surg Pak) Vol. 18 Issue 11 Pg. 684-7 (Nov 2008) ISSN: 1022-386X [Print] Pakistan
• PMID: 18983791 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Dipeptides
• Ammonia
• ornithylaspartate

Topics

• Adult
• Aged
• Ammonia (blood)
• Cognition
• Dipeptides (administration & dosage, therapeutic use)
• Female
• Health Status Indicators
• Hepatic Encephalopathy (drug therapy, physiopathology)
• Humans
• Hyperammonemia (drug therapy)
• Infusions, Intravenous
• Liver Cirrhosis (complications, physiopathology)
• Male
• Middle Aged
• Postprandial Period (drug effects)