L-ornithine-L-aspartate / Generic mfg. - LARVOL DELTA

ABERNETHY SYNDROME – AN IRREVERSIBLE CAUSE OF HEPATIC ENCEPHALOPATHY? (UEGW 2026) - "Serum ammonia levels were elevated (114 mmol/L).In this context, the patient's cognitive and motor impairments were attributed to hepatic encephalopathy; however, no clinical improvement was observed with lactulose and zinc therapy between ages 13 and 14, leading to discontinuation of treatment. At 20 years, he initiated follow-up with an adult hepatology team, with plans for brain MRI and a renewed therapeutic trial with L-ornithine L-aspartate and rifaximin.Abernethy syndrome represents a cause of non-cirrhotic hepatic encephalopathy. Early recognition and appropriate management may help mitigate neurological injury; however, it remains uncertain whether they effectively prevent permanent neurological deficits, and whether, in advanced stages, specific therapies such as liver transplantation can still provide meaningful clinical benefit."

CNS Disorders • Hepatic Encephalopathy • Hepatology • Movement Disorders

ACUTE ESOPHAGEAL NECROSIS (GURVITS' ESOPHAGUS) MIMICKING VARICEAL HEMORRHAGE IN A PATIENT WITH DECOMPENSATED LIVER DISEASE (UEGW 2026) - "Initial impression was variceal versus peptic ulcer bleeding; blood transfusion, esomeprazole, and octreotide infusion were initiated...Worsening sensorium prompted treatment for hepatic encephalopathy (lactulose, rifaximin, L-ornithine L-aspartate). Ceftriaxone was given for spontaneous bacterial peritonitis prophylaxis. Fluids and electrolytes were corrected. However, given clinical decline, the family opted for palliative care with transition to home-based management."

Clinical • Acute Kidney Injury • Cardiovascular • Chronic Cough • Chronic Kidney Disease • CNS Disorders • Cough • Diabetes • Diabetic Nephropathy • Fibrosis • Gastrointestinal Disorder • Heart Failure • Hematological Disorders • Hepatic Encephalopathy • Hepatology • Immunology • Liver Cirrhosis • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Nephrology • Peptic Ulcer • Renal Disease • Respiratory Diseases • Type 2 Diabetes Mellitus

Effects of dietary L-Ornithine L-Aspartate supplementation on growth performance, immune function, and intestinal health in lipopolysaccharide-challenged broilers. (PubMed, Poult Sci) - "In conclusion, dietary OA supplementation could improve growth performance in broilers by alleviating inflammation, improving immune homeostasis and intestinal health, which may be associated with modulation of the splenic TLR4/MyD88 signaling pathway. Based on a comprehensive evaluation of growth performance, immune regulation, intestinal health, and inflammatory responses, 400 mg/kg was identified as the optimal dietary inclusion level under the conditions of the present study."

IO biomarker • Journal • Oncology • IL1B • IL6 • MYD88 • TLR4 • TNFA

Dietary L-Ornithine L-Aspartate Alleviates Ammonia Load and Improves Hepatic Health in Largemouth Bass (Micropterus salmoides). (PubMed, Animals (Basel)) - "Furthermore, supplementation with 0.07-0.08% LOLA significantly enhanced glutathione peroxidase and superoxide dismutase activities in both serum and liver, as well as serum levels of lysozyme and immunoglobulin M. Additionally, compared with the OA9 group, the LOLA9 group showed more pronounced changes in TOR-S6K1-related markers, ammonia load, antioxidant and immune parameters. Overall, while no significant growth enhancement was observed, these biochemical and physiological modifications suggest that LOLA supplementation is associated with alterations in nitrogen metabolism, antioxidant, and immune indices in largemouth bass, but further studies are needed to confirm the functional significance of these changes."

Journal

Quality of Life in Patients with Hepatic Encephalopathy Treated with Rifaximin: A Systematic Review. (PubMed, J Clin Med) - "In comparative studies, rifaximin showed QoL outcomes comparable to those of lactulose, L-ornithine L-aspartate, and combination regimens. However, given the limitations of available evidence and the heterogeneity in study designs, HE phenotypes, QoL instruments, and outcome reporting, these findings should be interpreted with caution. Further high-quality comparative trials, particularly in patients with recurrent overt HE and in prophylactic settings, are needed to confirm these findings."

HEOR • Journal • Review • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Immunology • Liver Cirrhosis

Reducing the Risk of Overt Hepatic Encephalopathy Recurrence: A Narrative Review. (PubMed, J Clin Transl Hepatol) - "Rifaximin is recommended as add-on therapy to lactulose when an additional OHE episode occurs. Oral L-ornithine-L-aspartate may reduce the risk of OHE recurrence in patients with cirrhosis. Investigational agents include nitazoxanide, fecal microbiota transplantation, and the use of artificial intelligence, app-based technology, and wearable devices to facilitate acute and prophylactic management of HE."

Journal • Review • Cardiovascular • CNS Disorders • Constipation • Diabetes • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hepatic Encephalopathy • Hepatology • Hypertension • Immunology • Infectious Disease • Liver Cirrhosis • Metabolic Disorders • Portal Hypertension • Sarcopenia • Transplantation

A universal and green qNMR method for the determination of the content and amino acid ratio in three kinds of L-ornithine-L-aspartate preparations with different matrixs. (PubMed, J Pharm Biomed Anal) - "This qNMR approach enables simultaneous determination of active ingredient content and amino acid ratio across three different LOLA dosage forms with excellent compatibility, speed, and accuracy. By offering a unified, green, and versatile analytical solution, this work could further extend the application of qNMR to the multicomponent quality assessment of multi‑dosage‑form pharmaceutical preparations."

Journal • CNS Disorders • Hepatic Encephalopathy

An Open-Label, Bayesian Adaptive Phase II Clinical Study in HR+/HER2- Advanced Breast Cancer After Progression on Standard Therapy (clinicaltrials.gov) - P2 | N=60 | Recruiting | Sponsor: Fudan University | N=40 ➔ 60 | Trial completion date: Aug 2027 ➔ Dec 2027 | Trial primary completion date: Aug 2026 ➔ Jun 2027

Enrollment change • Trial completion date • Trial primary completion date • Breast Cancer • HER2 Breast Cancer • HER2 Negative Breast Cancer • Hormone Receptor Positive Breast Cancer • Oncology • Solid Tumor • ER • HER-2 • PGR

L-Ornithine-L-aspartate enhances growth performance and nitrogen metabolism via modulation of intestinal amino acid transporters and microbiota in broilers. (PubMed, J Anim Sci Biotechnol) - "In summary, while both forms are beneficial, OA is superior to the physical mixture of ornithine and aspartic acid in improving broiler performance. This advantage of the OA was correlated with the up-regulated intestinal AA transporters, improved the digestibility of nutrients such as ornithine, and the modulated gut microbiota towards a butyrate-producing profile, coupled with increased hepatic OAT activity."

Journal • SLC1A5

Ammonia is an inconsistent marker of clinical outcomes in people with cirrhosis and hepatic encephalopathy: evidence from ten pooled systematic reviews and meta-analyses (EASL 2026) - " Ten Cochrane systematic reviews evaluating, in turn, L-acetyl-carnitine, non-absorbable disaccharides, branched-chain amino acids, flumazenil, L-ornithine-L-aspartate, ammonia-lowering agents, probiotics, rifaximin, other antibiotics, and dopaminergic agents were included. Associations between ammonia and clinical outcomes were inconsistent across all trials, which likely represents between-study methodological heterogeneity. A higher ammonia at baseline was associated with a larger relative treatment effect on HE outcomes, but this likely reflects baseline risk and trial context rather than a useful biomarker of responsiveness to treatment. Hence, the clinical utility of blood ammonia measurement remains unclear."

Clinical • Clinical data • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Hepatology • Immunology

L-ornithine-L-aspartate enhances protein anabolism and growth performance in broilers by modulating the liver-NH3/Gln-muscle axis. (PubMed, J Adv Res) - "OA safely improves broiler growth and slaughter performance by enhancing Gln production and NH3 detoxification through the liver-muscle axis, and increasing protein synthesis and deposition. With a confirmed 5-fold safety margin, OA serves as a safe and novel feed additive to optimize nitrogen metabolism in poultry production."

Journal • Hepatology • Sarcopenia

An Open-Label, Bayesian Adaptive Phase II Clinical Study in HR+/HER2- Advanced Breast Cancer After Progression on Standard Therapy (clinicaltrials.gov) - P2 | N=40 | Recruiting | Sponsor: Fudan University | N=20 ➔ 40

Enrollment change • Breast Cancer • HER2 Breast Cancer • HER2 Negative Breast Cancer • Hormone Receptor Positive Breast Cancer • Oncology • Solid Tumor • ER • HER-2 • PGR

Therapeutic efficacy of ASS1 combined with LOLA in the treatment of hyperammonemia in mice (PubMed, Zhong Nan Da Xue Xue Bao Yi Xue Ban) - "Recombinant ASS1 protein obtained by prokaryotic expression exhibits stable and well-defined biological activity, with catalytic function significantly influenced by temperature and pH and displaying clear enzymatic kinetic characteristics. In an NH4Cl-induced mouse model of hyperammonemia, combined application of ASS1 and LOLA showed a more stable and effective ammonia-lowering effect than monotherapy, demonstrating good synergistic effects. These findings provide a new enzymatic intervention strategy for the treatment of hyperammonemia, lay a theoretical foundation for the development of combination ammonia-lowering therapies, and indicate potential application prospects."

Journal • Preclinical • ASS1

Electrochemical and quantum chemical exploration on L-ornithine L-aspartate as a sustainable corrosion inhibitor for AISI 1018 steel in acidic environment. (PubMed, Sci Rep) - No abstract available

Journal

Ammonia Detoxification Inhibits Liver Metastasis by Reshaping Hepatic Microenvironment. (PubMed, Adv Sci (Weinh)) - "Strikingly, the ammonia detoxifying agent L-ornithine-L-aspartate (LOLA) potently promotes ammonia removal, thereby reshaping the hepatic microenvironment with decrease of MAFs and LDNs and increase of Ifi27l2a+ monocyte-macrophages, and reducing metastatic burden in liver metastasis mouse models. These results suggest that ammonia, a metabolic toxin, is required for the formation of the hepatic microenvironment favoring liver metastatic colonization, and highlight LOLA as a promising therapeutic strategy for treatment of liver metastasis by detoxifying pathological ammonia accumulation."

Journal • Oncology • IFI27

Role of Aspartate in Immune Response and Mortality in a Polymicrobial Sepsis Model: Insights from Metabolomics and Transcriptomics. (PubMed, Cells) - "Supplementation with L-ornithine L-aspartate (LOLA), an ASP source, improved survival in septic rats, enhanced bacterial clearance, and mitigated acute kidney injury...Consistently, patients with sepsis exhibited lower intracellular ASP levels in PBMCs than healthy volunteers. Together, these results support a critical role for ASP in maintaining immune competence during sepsis and suggest that intracellular ASP may serve as a biomarker of immune suppression and a potential therapeutic target."

IO biomarker • Journal • Acute Kidney Injury • Immune Modulation • Immunology • Infectious Disease • Inflammation • Nephrology • Renal Disease • Septic Shock

Dietary supplemental l-Ornithine l-Aspartate reduced lipid deposition and alleviated mitochondrial oxidative stress and inflammatory responses in the liver of broiler chicken. (PubMed, Poult Sci) - "In addition, OA increased mitochondrial membrane oxygen consumption rate, mitigated liver mitochondrial dysfunction, reduced reactive oxygen species production, and decreased inflammatory responses by inhibiting the expression of NF-κB signaling pathway and lowering the levels of inflammatory factors, including IL-1β and TNF-α. In conclusion, dietary OA addition would be not only a therapeutic measure for liver health but also a potential strategy to prevent abdominal fat deposition."

Journal • Inflammation • Metabolic Disorders • ACACA • IL1B • TNFA

Hepatic encephalopathy in liver cirrhosis (PubMed, Dtsch Med Wochenschr) - "The acute treatment of overt hepatic encephalopathy (OHE) is primarily based on the administration of lactulose, optionally supplemented with intravenous L-ornithine-L-aspartate. For secondary prophylaxis lactulose is the treatment of choice and in patients with recurrent episodes, the combination of rifaximin and lactulose is well established...In cases of refractory HE or recurrent relapses despite guideline-based treatment, liver transplantation should always be considered. In general, early detection and individualized management of HE is essential to preserve and improve quality of life, prognosis, and functional independence of the affected patients."

Journal • Review • Cognitive Disorders • Fibrosis • Gastroenterology • Hepatic Encephalopathy • Hepatology • Immunology • Inflammation • Liver Cirrhosis • Sarcopenia • Transplantation

Can ammonia scavenging treat MASLD? Evaluating the evidence for L-ornithine L-aspartate-A systematic review. (PubMed, Eur J Clin Invest) - "Preclinical evidence suggests that LOLA exerts pleiotropic hepatoprotective effects in MASLD by targeting hyperammonemia-induced fibrosis and metabolic dysregulation. While growing clinical data indicate benefits in biochemical normalization, structural improvement and symptom relief, further robust clinical research is required to validate these findings and establish LOLA as a standard therapeutic option for MASLD patients."

Journal • Review • Fatigue • Fibrosis • Hepatology • Immunology • Inflammation • Liver Failure • Metabolic Disorders • Metabolic Dysfunction-Associated Steatohepatitis • Metabolic Dysfunction-Associated Steatotic Liver Disease • AMPK • STK11

Aminoglycosides, vancomycin, and metronidazole for people with cirrhosis and hepatic encephalopathy. (PubMed, Cochrane Database Syst Rev) - "Due to low- or very low-certainty evidence, we do not know if aminoglycosides benefit hepatic encephalopathy compared to placebo or other potentially active agents. There may be a slight increase in the risks of mortality and serious adverse events with aminoglycosides compared to other agents, and of non-serious adverse events when compared to placebo and other antibiotics. We do not know if vancomycin or metronidazole improve clinically relevant outcomes. Only one trial assessed health-related quality of life."

Clinical • Journal • Review • Cardiovascular • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Hepatology • Hypertension • Immunology • Liver Failure • Portal Hypertension • IL7R

Phosphate binders suppress glutaminase activity for treatment of cirrhosis and hepatic encephalopathy murine models. (PubMed, Biochem Pharmacol) - "The pharmacology and pharmacodynamics of Pi binders (sevelamer and lanthanum carbonate) were evaluated in CCl4-induced cirrhosis and both type A and C HE murine models...They had better therapeutic effects than L-ornithine L-aspartate (OA). Pi deprivation weakened glutaminase enzymatic activity, lowering collagen and Alpha-smooth muscle actin (α-SMA) production in HSCs and ammonia production in both wild-type and GLS1-overexpressing IECs. Since Pi deprivation alleviates glutaminolysis and ammonia production by decreasing glutaminase activity, Pi binders might hold great promising to treat cirrhosis and HE."

Journal • Preclinical • CNS Disorders • Fibrosis • Hepatic Encephalopathy • Hepatology • Immunology • Liver Failure • GLS1

A Mysterious Case of Recurrent Confusion: An Unusual Presentation of Congenital Intrahepatic Portosystemic Shunt. (PubMed, Cureus) - "Due to multiple comorbidities, the patient was deemed unsuitable for shunt closure or liver transplantation but responded well to medical therapy with lactulose, rifaximin, sodium benzoate, glycerol phenylbutyrate, and L-ornithine L-aspartate, with no further episodes of encephalopathy on follow-up. This case underscores the importance of considering CPSS in adults presenting with hyperammonaemia and altered mental status in the absence of hepatic disease. Early recognition and multidisciplinary management are key to preventing recurrence and optimising outcomes."

Journal • Cardiovascular • CNS Disorders • Hepatic Encephalopathy • Hepatology • Transplantation

Medication Use Evaluation of L-Ornithine L-Aspartate (LOLA) Supplementation for the Treatment of Hepatic Encephalopathy (ASHP 2025) - No abstract available

CNS Disorders • Hepatic Encephalopathy • Hepatology

An Open-Label, Bayesian Adaptive Phase II Clinical Study in HR+/HER2- Advanced Breast Cancer After Progression on Standard Therapy (clinicaltrials.gov) - P2 | N=20 | Recruiting | Sponsor: Fudan University | Not yet recruiting ➔ Recruiting

Enrollment open • Breast Cancer • HER2 Breast Cancer • HER2 Negative Breast Cancer • Hormone Receptor Positive Breast Cancer • Oncology • Solid Tumor

Comparison of efficacy of rifaximin, probiotics and L-ornithine L-aspartate in overt hepatic encephalopathy: a randomized, phase IV, lactulose controlled clinical trial. (PubMed, Trials) - P4 | "This randomized controlled trial protocol will compare the efficacy of four proposed groups of medications to fill the gap in current knowledge."

Clinical • Clinical protocol • Journal • P4 data • CNS Disorders • Fibrosis • Gastroenterology • Hepatic Encephalopathy • Hepatology • Immunology • Liver Cirrhosis • Movement Disorders