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IV LOLA combo with lactulose and rifaximin effective in cirrhosis with hepatic encephalopathy: Study
![IV LOLA combo with lactulose and rifaximin effective in cirrhosis with hepatic encephalopathy: Study IV LOLA combo with lactulose and rifaximin effective in cirrhosis with hepatic encephalopathy: Study](https://medicaldialogues.in/h-upload/2022/02/18/750x450_170743-hepatic-encephalopathy.webp)
New Delhi: A recent study showed a combination of intravenous L-ornithine L-aspartate (LOLA) with lactulose and rifaximin to be better than lactulose and rifaximin alone for treatment of cirrhosis patients with overt hepatic encephalopathy (OHE) grade III-IV. The combination of LOLA with lactulose and rifaximin improved grades of HE, recovery time from encephalopathy with lower mortality at 28 days.
Considering the limited data on the use of LOLA in the treatment of overt HE, Barjesh Chander Sharma, Department of Gastroenterology, GB Pant Hospital, New Delhi, India, and colleagues aimed to evaluate the role of intravenous LOLA in patients of cirrhosis with OHE grade III-IV in their study published in the journal Hepatology.
The double-blind randomized placebo-controlled trial included 140 patients. They were randomized to receive a combination of LOLA, lactulose, and rifaximin (n = 70) or placebo, lactulose, and rifaximin (n = 70). LOLA was given as continuous IV infusion at a dose of 30 g over 24 h for 5 days. The researchers measured ammonia levels, endotoxins, TNF-α, and ILs on days 0 and 5. The improvement in the grade of HE at day 5 was the primary outcome.
Salient findings of the study include:
- Higher rates of improvement in grade of HE (92.5% vs. 66%), lower time to recovery (2.70 ± 0.46 vs. 3.00 ± 0.87 days), and lower 28-day mortality (16.4% vs. 41.8%) were seen in the LOLA group as compared with placebo.
- Levels of inflammatory markers were reduced in both groups.
- Significantly higher reductions in levels of blood ammonia, IL-6, and TNF-α were seen in the LOLA group.
"LOLA with lactulose and rifaximin combo is more effective than only lactulose and rifaximin in improving grades of HE, recovery time from encephalopathy, with lower 28-day mortality," the authors concluded.
Reference:
The study titled, "L-ornithine L-aspartate in acute treatment of severe hepatic encephalopathy: A double-blind randomized controlled trial," was published in the journal Hepatology.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751