title: 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).
  
  
  METHODS
  Randomized placebo controlled study.
  
  
  METHODS
  The Aga Khan University Hospital, Karachi in the year 2003-2004.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  In cirrhotic patients with advanced hepatic encephalopathy treatment with LOLA was safe and associated with relatively rapid improvement and shorter hospital stay.
authors.affiliation: Department of Medicine, The Aga Khan University Hospital, Karachi. shahab.abid@aku.edu
authors.forename: Shahab
authors.initials: S
authors.lastname: Abid
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
authors.forename: Khalid
authors.initials: K
authors.lastname: Mumtaz
authors.forename: Muhammad
authors.initials: M
authors.lastname: Islam
authors.forename: Zaigham
authors.initials: Z
authors.lastname: Abbas
authors.forename: Hasnain Ali
authors.initials: HA
authors.lastname: Shah
authors.forename: Saeed
authors.initials: S
authors.lastname: Hamid
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D004151:Dipeptides / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005947:Glucose / Q000627:therapeutic use; D006501:Hepatic Encephalopathy / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D007792:Lactulose / Q000627:therapeutic use; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D004151:Dipeptides; D005765:Gastrointestinal Agents; D008795:Metronidazole; D007792:Lactulose; D005947:Glucose; C002939:ornithylaspartate