Intravenous therapy of hepatic encephalopathy with L-ornithine l-aspartate (Lola) is safe and very effective

Introduction:

Hepatic encephalopathy (HE) is a frequent complication in liver cirrhosis which not only restricts the daily quality of life in our patients, but can also be lethal during acute decompensation. An early and targeted therapy against this condition is therefore very important for the further prognosis of the patients. The Aim of this retrospective single-center study was therefore to investigate therapy response and side-effects of intravenous therapy with L-ornithine l-aspartate (Lola) which still is a subject of debate.

Patients and Methods:

During the period of 11/2015 till 05/2018 a total of 113 patients with hepatic encephalopathy of different stages using Westhaven criteria were treated at our department. However, 62% were male and 38% were female patients. Alcohol abuse presented as the most common cause of liver cirrhosis in our cohort by 38.1% (Figure 1).

Results:

The most common cause of underlying hepatic encephalopathy was an acute infection (e.g. spontaneous bacterial peritonitis, pneumonia) with 40.7% (Figure 2). All patients received an intravenous treatment with Lola; oral therapy with this drug was not used. Middle duration of the treatment was 11.4 days. No serious adverse reactions or side-effects were documented or reported by our patients. Middle values of ammonia were high with 228.5 µmol/l initially and decreased significantly to 124 µmol/l following Lola therapy. Fortunately, 72% of our patients recovered successfully whereas the rest of our cohort (28%) deceased at the intensive care unit.

Conclusion:

Intravenous Lola treatment is effective and safe in the therapy of HE in patients with liver cirrhosis and therefore should be initiated immediately.