Is L-ornithine-L-aspartate Effective in Hepatic Encephalopathy? or is it Just a Myth?

Author(s): Ukasha Habib, Arshad Maqbool, Muhammad Humza Qamar, Sidra Shahid Mubasher, Ruchir Paladiya, Marya Khalid Ali, Nabeel Hussain, Alejandra Guadalupe Ponce Alvizo, Rida Tafveez, Azka Ali, Annerin Maxwe

Hepatic Encephalopathy (HE), a complication of chronic liver disease, presents with neurological and psychiatric symptoms. It has four grades. Minimal Hepatic Encephalopathy (MHE) is the mildest form of HE. Over the last two decades, many Randomized Controlled Trials (RCTs) have been performed to understand the role of various treatments in HE. L-Ornithine L-aspartate (LOLA) has also been studied. It is a stable salt of two amino acids; L-Ornithine and L-aspartate. It acts in the liver to help utilize extra ammonia by the urea cycle and hence lowers the ammonia levels. This review aims to understand the role of LOLA in HE, MHE, and as a prophylaxis. PubMed was used as a search engine. A total of seven articles were retrieved. Our results demonstrated that LOLA can be very effective in lowering the ammonia levels and hence is not only effective for MHE and prophylaxis, but can play a very significant role in the treatment of HE.