Encephalopathy ornithine aspartate

Latent encephalopathy, detectable by psychometric tests (s. p. 202), is frequent experience has shown that it can rapidly become manifest. Of the urea-cycle amino acids suitable for therapy, ornithine aspartate has proved the most successful - also as an i.v. infusion in the postoperative phase, (s. pp 279, 733)... 

Ammonia metabolism within the muscle may be improved by the administration of L-omithine-L- aspartate (LOLA). Controlled trials suggest that enteral and parenteral formulations of ornithine aspartate significantly reduce blood ammonia levels and have useful therapeutic effects in patients with cirrhosis and encephalopathy (Kircheis et al., 1997 Stauch et al., 1998). Poo et al. (2006) recently showed in a randomized, lactulose-controlled study of oral ornithine-aspartate in 20 patients with clinically overt HE that LOLA in contrast to lactulose significantly improved parameters of mental status, number connection test scores, asterixis scores and EEG. Both lactulose and LOLA reduced serum ammonia levels and improved quaUty of life scores. Since only 20 patients were included in this study the results cannot be considered proof for the superiority of LOLA compared to lactulose, while the data underscore the effect of both agents. Ornithine aspartate is well tolerated in general. From a theoretical point of view the combination of disaccharides and ornithine aspartate may be useful in patients with insufficient efficacy of only one of the two drugs. 

Kircheis, G., Nilius, R., Held, C., Berndt, H., Buchner, M., Gortelmeyer, R., Hendridis, R., Kruger, B., Kuklinski, B., Meister, H., Otto, H.-J., Rink, C., Rosch, W., Stanch, S. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy results of a placebo-controlled, double-blind study. Hepatology 1997 25 1351-1360... 

Stauch, S., Kircheis, G., Adler, G., Becker, K., Ditschuneit, H., Gortelmeyer, R., Hendricks, R., Heuser, A., Karoff, C., Malfertheiner, R, Mayer, D., Rosch, W, Steffens, J. Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy results of a placebo-controlled double-blind study. X. Hepatol 1998 28 856-864... 

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