{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T10:49:47Z","timestamp":1792838987810,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,4,25]],"date-time":"2013-04-25T00:00:00Z","timestamp":1366848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2013,5]]},"abstract":"Abstract<\/jats:title>Background and Aim<\/jats:title>Several randomized, controlled trials that evaluated the effectiveness of l<\/jats:sc>\u2010ornithine\u2010l<\/jats:sc>\u2010aspartate (LOLA<\/jats:styled-content>) in the treatment of hepatic encephalopathy (HE<\/jats:styled-content>) have been published recently. The purpose of this study was to update the meta\u2010analysis to reevaluate the safety and efficacy of LOLA<\/jats:styled-content> on HE<\/jats:styled-content> in patients with cirrhosis.<\/jats:p><\/jats:sec>Methods<\/jats:title>The following databases were searched from inception to J<\/jats:styled-content>une 2012: M<\/jats:styled-content>edline, E<\/jats:styled-content>mbase, and the C<\/jats:styled-content>ochrane C<\/jats:styled-content>entral R<\/jats:styled-content>egister of C<\/jats:styled-content>ontrolled T<\/jats:styled-content>rials (Issue 6). Differences between groups were assessed by the pooled risk ratio (RR<\/jats:styled-content>) or mean difference (MD<\/jats:styled-content>). Possible sources of heterogeneity were assessed by sensitivity analyses.<\/jats:p><\/jats:sec>Results<\/jats:title>Eight randomized controlled trials with 646 patients were included. When comparing placebo\/no\u2010intervention control, LOLA<\/jats:styled-content> was significantly more effective in the improvement of HE<\/jats:styled-content> in the total (RR<\/jats:styled-content>: 1.49, 95% confidence interval [CI<\/jats:styled-content>]: 1.10 to 2.01), overt HE<\/jats:styled-content> (RR<\/jats:styled-content>: 1.33, 95% CI<\/jats:styled-content>: 1.04 to 1.69), and minimal HE<\/jats:styled-content> patients (RR<\/jats:styled-content>: 2.25, 95% CI<\/jats:styled-content>: 1.33 to 3.82). Furthermore, the reduction of fasting ammonia significantly favored LOLA<\/jats:styled-content> (post\u2010treatment value, MD<\/jats:styled-content>: \u221218.26, 95% CI<\/jats:styled-content>: \u221226.96 to \u22129.56; change, MD<\/jats:styled-content>: 8.59, 95% CI<\/jats:styled-content>: 5.22 to 11.96). The tolerance ratio, incidence of adverse events, and mortality were not significantly different between LOLA<\/jats:styled-content> and the placebo\/no\u2010intervention control. LOLA<\/jats:styled-content> and lactulose demonstrated similar effectiveness in the improvement of HE<\/jats:styled-content> (RR<\/jats:styled-content>: 0.88, 95% CI<\/jats:styled-content>: 0.57 to 1.35).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>LOLA<\/jats:styled-content> benefits both overt and minimal HE<\/jats:styled-content> patients in the improvement of HE<\/jats:styled-content> by reducing the serum ammonia concentration compared with the placebo\/no\u2010intervention control. Further, evaluations between LOLA<\/jats:styled-content> and other effective treatments are needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.12142","type":"journal-article","created":{"date-parts":[[2013,2,21]],"date-time":"2013-02-21T07:58:55Z","timestamp":1361433535000},"page":"783-792","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":77,"title":["l<\/scp>\u2010ornithine\u2010l<\/scp>\u2010aspartate for hepatic encephalopathy in patients with cirrhosis: A meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","volume":"28","author":[{"given":"Ming","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Liver Disease Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"},{"name":"Department of Digestive Interventional Radiology Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiping","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Liver Disease Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"},{"name":"Department of Digestive Interventional Radiology Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingshun","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Liver Disease Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"},{"name":"Department of Digestive Interventional Radiology Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiming","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Liver Disease Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"},{"name":"Department of Digestive Interventional Radiology Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Liver Disease Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"},{"name":"Department of Digestive Interventional Radiology Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi'an Shaanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.31250"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.11.015"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(01)00129-5"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1746-6342.2006.03215.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23128"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2007.122176"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(02)01477-8"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510250609"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.03964.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11011-007-9060-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcp152"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003044.pub2"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003047.pub2"},{"issue":"2","key":"e_1_2_6_15_1","article-title":"Benzodiazepine receptor antagonists for hepatic encephalopathy","author":"Als\u2010Nielsen B","year":"2004","journal-title":"Cochrane Database Syst. 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