{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:55:32Z","timestamp":1792839332865,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T00:00:00Z","timestamp":1514332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,12,27]],"date-time":"2017-12-27T00:00:00Z","timestamp":1514332800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:p>High\u2010quality data on the efficacy of L\u2010ornithine L\u2010aspartate (LOLA) in patients with cirrhosis and bouts of overt hepatic encephalopathy (OHE) are missing. We evaluated the efficacy of intravenous LOLA in the reversal of bouts of OHE in patients with cirrhosis. In this prospective, double\u2010blind, randomized, placebo\u2010controlled trial conducted at two tertiary care institutes in India, 370 patients with cirrhosis and bouts of OHE were screened. After exclusion, 193 (52.16%) patients were randomized to receive either intravenous infusions of LOLA (n\u2009=\u200998), 30\u2009g daily, or placebo (n\u2009=\u200995) for 5 days. Standard of care treatment (including lactulose and ceftriaxone) was given in both groups. Randomization was done centrally (http:\/\/www.sealedenvelope.com\/). All study personnel were blinded to the treatment assignment. Fasting venous ammonia levels were estimated daily from 0 to 5 days. Serum tumor necrosis factor\u2010alpha, interleukins, hemogram, and liver and renal function tests were performed at days 0 and 5. Primary outcome was mental state grade at day 5 of treatment. The grade of OHE was significantly lower in the LOLA group (compared to placebo) on days 1\u20104 but not on day 5. The mean time taken for recovery was lower in the LOLA group compared to the placebo group (1.92\u2009\u00b1\u20090.93 versus 2.50\u2009\u00b1\u20091.03 days,<jats:italic toggle=\"yes\">P<\/jats:italic>\u2009=\u20090.002; 95% confidence interval \u22120.852 to \u22120.202). Venous ammonia at day 5 and length of hospital stay were significantly lower in the LOLA group. No significant difference in interleukins was seen between the groups.<jats:italic toggle=\"yes\">Conclusion<\/jats:italic>: In patients with bouts of OHE, intravenous LOLA (as an add\u2010on therapy to lactulose and ceftriaxone) significantly improves the grade of OHE over days 1\u20104, but not on day 5, and decreases venous ammonia, time of recovery, and length of hospital stay. (H<jats:sc>epatology<\/jats:sc>2018;67:700\u2010710).<\/jats:p>","DOI":"10.1002\/hep.29410","type":"journal-article","created":{"date-parts":[[2017,7,27]],"date-time":"2017-07-27T15:42:43Z","timestamp":1501170163000},"page":"700-710","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":82,"title":["L\u2010ornithine L\u2010aspartate in bouts of overt hepatic encephalopathy"],"prefix":"10.1097","volume":"67","author":[{"given":"Sandeep Singh","family":"Sidhu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology,Dayanand Medical College and Hospital,Ludhiana,Punjab,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barjesh Chander","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Hepatology,Institute of Liver & Biliary Sciences,New Delhi,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omesh","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Dayanand Medical College and Hospital,Ludhiana,Punjab,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Kishore","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology,Dayanand Medical College and Hospital,Ludhiana,Punjab,India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Biochemistry,Dayanand Medical College and Hospital,Ludhiana,Punjab,India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,12,27]]},"reference":[{"key":"hep29410-bib-0001-20241017","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/hep.27210","article-title":"Hepatic encephalopathy in chronic liver 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