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Randomized Controlled Trial
. 2024 May 24;14(1):11862.
doi: 10.1038/s41598-024-62293-8.

Intravenous versus oral 'L-ornithine-L-aspartate' in overt hepatic encephalopathy: a randomized comparative study

Ashok Jhajharia  1   2 , Shashank Singh  3 , Sangeeta Jana  3 , Prachis Ashdhir  3 , Sandeep Nijhawan  3
Affiliations
Randomized Controlled Trial

Intravenous versus oral 'L-ornithine-L-aspartate' in overt hepatic encephalopathy: a randomized comparative study

Ashok Jhajharia et al. Sci Rep. .

Abstract

Hepatic encephalopathy (HE), a morbid ordeal affecting chronic liver disease patients always insists for the search of a rational, superior & infallible agent beyond the time-proven standards i.e., Lactulose & Rifaximin. In this RCT, we compared the efficacy of intravenous (IV) L-ornithine-L-aspartate(LOLA) versus Oral LOLA in patients with chronic liver disease(CLD) enduring overt Hepatic Encephalopathy(OHE). 40 CLD patients with OHE were randomly assigned IV or oral LOLA in a 1:1 ratio. Patients were graded for HE and monitored for serum ammonia levels from day 1 to day 5. The aim was to compare IV versus oral LOLA efficacy in HE grades improvement and its correlation with ammonia levels. The study was registered with clinical trials registry-India, CTRI/2020/12/029943. Baseline characteristics of patients in both groups were similar. The mean difference in ammonia levels from day 1 to day 5 was 55.4 ± 32.58 µmol/L in the IV LOLA group and 60.75 ± 13.82 µmol/L in the oral LOLA group (p = 0.511). Significant reductions in ammonia levels were observed from day 1 to day 5 within each group (p < 0.001). HE grade & ammonia correlated positively in both groups. LOLA, regardless of administration route, has demonstrated efficacy in OHE.

Keywords: l-ornithine-l-aspartate (LOLA); Child turcotte pugh (CTP); Overt hepatic encephalopathy (OHE); Randomized controlled trial (RCT).

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of the study.
Figure 2
Figure 2
Line graph: day-wise linearity of serum ammonia level in both groups.
Figure 3
Figure 3
Scatter plot: HE grade & ammonia level correlation in both groups.
See this image and copyright information in PMC

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