ArticleJournal of clinical and experimental hepatology2018
Efficacy of l-Ornithine l-Aspartate for the Treatment of Hepatic Encephalopathy and Hyperammonemia in Cirrhosis: Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Article in Journal of clinical and experimental hepatology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
34 citing papers in PubMed, 4 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- CROATIAN GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF PORTAL HYPERTENSION.Acta clinica Croatica · 2024Guideline
- KASL clinical practice guidelines for liver cirrhosis: Varices, hepatic encephalopathy, and related complications.Clinical and molecular hepatology · 2020Guideline
- Beneficial effects of L-ornithine L-aspartate for prevention of overt hepatic encephalopathy in patients with cirrhosis: a systematic review with meta-analysis.Metabolic brain disease · 2020Pooled it
- L-ornithine L-aspartate for prevention and treatment of hepatic encephalopathy in people with cirrhosis.The Cochrane database of systematic reviews · 2018Pooled it
- Intravenous versus oral 'L-ornithine-L-aspartate' in overt hepatic encephalopathy: a randomized comparative study.Scientific reports · 2024Trial
- "L-Ornithine Liposomal Nanoparticles Targeting the Proline Cycle: A Mechanistic Perspective for Ammonia-Driven Hepatic Encephalopathy".Cell biochemistry and biophysics · 2026Review
- Effects of dietary L-Ornithine L-Aspartate supplementation on growth performance, immune function, and intestinal health in lipopolysaccharide-challenged broilers.Poultry science · 2026Article
- Review
- Dietary L-Ornithine L-Aspartate Alleviates Ammonia Load and Improves Hepatic Health in Largemouth Bass (Animals : an open access journal from MDPI · 2026Article
- Review
- Novel roles of ammonia in physiology and cancer.Journal of molecular cell biology · 2025Review
- The therapeutic landscape of citrin deficiency.Journal of inherited metabolic disease · 2024Review
- Redefining the Role of Ornithine Aspartate and Vitamin E in Metabolic-Dysfunction-Associated Steatotic Liver Disease through Its Biochemical Properties.International journal of molecular sciences · 2024Article
- The assessment and management of cirrhotic patients with encephalopathy.United European gastroenterology journal · 2024Review
- Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management.World journal of gastroenterology · 2023Review
- Uncovering Actions of Type 3 Deiodinase in the Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD).Cells · 2023Article
- Ornithine Aspartate and Vitamin-E Combination Has Beneficial Effects on Cardiovascular Risk Factors in an Animal Model of Nonalcoholic Fatty Liver Disease in Rats.Biomolecules · 2022Article
- Therapeutic mechanisms and beneficial effects of non-antidiabetic drugs in chronic liver diseases.Clinical and molecular hepatology · 2022Review
- Neurological monitoring and sedation protocols in the Liver Intensive Care Unit.Metabolic brain disease · 2022Review
- Review article: current and emerging therapies for the management of cirrhosis and its complications.Alimentary pharmacology & therapeutics · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectivesl-Ornithine l-Aspartate (LOLA) is a mixture of two endogenous amino acids with the capacity to fix ammonia in the form of urea and/or glutamine. Its' efficacy for the treatment of Hepatic Encephalopathy (HE), a known hyperammonemic disorder, remains the subject of debate. This study quantitatively analyzed the efficacy of LOLA in patients with cirrhosis and HE.
methodsEfficacy was defined as the extent of lowering of blood ammonia and improvement of mental state assessed in clinically overt HE (OHE) by Westhaven criteria or psychometric testing for assessment of Minimal HE (MHE). Appropriate keywords were used for electronic and/or manual searches of databases to identify RCTs for inclusion. Study quality and risk of bias were assessed using the Jadad Composite Scale together with The Cochrane Scoring Tool. Random Effects Models were used to express pooled Risk Ratio (RR) or Mean Difference (MD) with associated 95% Confidence Intervals (CI).
results10 RCTs (884 patients) were included. Regression analysis showed no evidence of publication bias or other small study effects. Eight RCTs had low risk of bias by Jadad/Cochrane criteria. Comparison with placebo/no intervention controls revealed that LOLA was significantly more effective for improvement of mental state in all types of HE (RR 1.36 (95% CI 1.10-1.69),
conclusionLOLA appears to improve mental state and lower ammonia in patients with HE or MHE. Further studies are required in some subgroups of HE and in the era of HE reclassification.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.