medigraphic.com
Órgano Oficial de la Asociación Mexicana de Hepatología

2011, Number S2

<< Back Next >>

Ann Hepatol 2011; 10 (S2)

Critical analysis of studies evaluating the efficacy of infusion of L-ornithine L-aspartate in clinical hepatic encephalopathy in patients with liver failure

Pérez HJL, Higuera TF, Serralde-Zúńiga AE, Abdo FJM

Language: English
References: 16
Page: 66-69
PDF size: 41.36 Kb.


ABSTRACT

Introduction. Hepatic encephalopathy (HE) refers to a complex neuropsychiatric syndrome that is progressive but potentially reversible and may have a significant impact on quality of life, as it is characterized by alterations in cognitive function, behavior and personality as well as transient neurological symptoms and electroencephalographic abnormalities. Objective. The aim of this study was to evaluate scientific evidence for the effectiveness and safety of LOLA infusions for treatment of clinical hepatic encephalopathy in patients with chronic liver disease. Material and methods. We included all randomized, controlled, double-blind, and humans’ studies that were published in indexed journals. Results. Were identified 48 references (17 using PubMed, 12 using Medline and 19 using the Cochrane database). Of these, six were selected as having met the inclusion criteria. A total of 623 patients were randomized in these publications. Conclusion. The available scientific evidence supports the adoption of LOLA infusion as a treatment for clinical encephalopathy in patients with liver failure, because it has been shown to improve neuropsychiatric status and decrease serum levels of ammonia with a low incidence of adverse effects (less than 5%).


REFERENCES

  1. Gitlin N. Hepatic encephalopathy. In: Zakim D Boyer TD (eds.). Hepatology: a textbook of liver disease. Vol. 1. 3rd. Ed. Philadelphia: W.B. Saunders; 1996, p. 605-17.

  2. Blei AT, Cordoba H. Practice Parameters Committee of the American College of Gastroenterology. Hepa tic encephalopathy. Am J Gastroenterol 2001; 96: 1968-76.

  3. Clemmesen JO, Kondrup J, Ott P. Splachnic and leg exchange of amino acids and ammonia in acute liver failure. Gastroenterology 2000; 118: 1131-39.

  4. Lockwood AH, McDonald JM, Reiman RE. The dynamics of ammonia metabolism in man. Effects of liver disease and hyperammonemia. J Clin Invest 1979; 63: 449-60.

  5. Felipo V, Butterworth RF. Neurobiology of ammonia. Progr Neurobiol 2002; 67: 259-79.

  6. Lai JC, Cooper AJ. Brain alpha-ketoglutarate dehydrogenase complex: kinetic properties, regional distribution, and effects of inhibitors. J Neurochem 1986; 47: 1376-86.

  7. Olde DSW, Deutz NE, Dejong CH, Soeters PB, Jalan R. Interorgan ammonia metabolism in liver failure. Neurochem Int 2002; 41: 177-88.

  8. Haussinger D. Regulation of hepatic ammonia metabolism: the intercellular glutamine cycle. Adv Enzyme Regul 1986; 25: 159-80.

  9. Staedt U, Leweling H, Gladisch R, Kortsik C, Hagmuller E, Holm E. Effects of ornithine aspartate on plasma ammonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. J Hepatol 1993; 19: 424-30.

  10. Rose C, Michalak A, Rao KV, Quack G, Kircheis G, Butterworth RF. L-ornithine L-aspartate lowers plasma and cerebrospinal fluid ammonia and prevents brain edema in rats with acute liver failure. Hepatology 1999; 30: 636-40.

  11. Kircheis G, Nilius R, Held C, Berndt H, Buchner M, Görtelmer R, et al. Therapeutic efficacy of L-ornithine L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, doubleblind study. Hepatology 1997; 25: 1351-60.

  12. Staedt U, Leweling H, Gladisch R, Kortsik C, Hagmüller E, Holm E. Effects of L-ornithine L-aspartate on plasma ammonia and plasma amino acids in patients with cirrhosis. A double-blind, randomized study using a four-fold crossover design. J Hepatol 1993; 19: 424-30.

  13. Kircheis G, Wettstein M, Dahl S, Häussinger D. Clinical efficacy of L-ornithine L-aspartate in the management of hepatic encephalopathy. Metab Brain Disease 2002; 17: 453-62.

  14. Ahmad I, Khan AA, Alam A, Dilshad A, Butt AK, Shafqat F, et al. L-ornithine L-aspartate infusion efficacy in hepatic encephalopathy. J Coll Physicians Surg Pak 2008; 18: 684-87.

  15. Acharya SK, Bhatia V, Sreenivas V, Khanal S. Efficacy of L-ornithine L-aspartate in acute liver failure: a doubleblind, randomized, placebo-controlled study. Gastroenterology 2009; 136: 2159-68.

  16. Abdo-Francis JM, Pérez HJL, Hinojosa RA, Hernández-Vásquez J. Use of L-ornitin L-aspartate (LOLA) reduce time of hospital stay in patients with hepatic encephalopathy. Rev Gastroenterol Mex 2010; 75(2): 135-41.




2020     |     www.medigraphic.com