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

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 (20g/d) or placebo, both dissolved in 250mL 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.