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Branched chain enriched amino acid solutions in the treatment of hepatic encephalopathy a controlled trial



Branched chain enriched amino acid solutions in the treatment of hepatic encephalopathy a controlled trial



Italian Journal of Gastroenterology 17(1): 5-10



The efficacy of a specially formulated amino acid (AA) mixture was compared to that of lactulose in a prospective randomized trial performed on 48 cirrhotics patients with hepatic encephalopathy (HE). The patients were randomly assigned to one of the following 3 different therapeutic protocols: group A: lactulose + hypertonic glucose; group B: special AA mixture (Trade name BS666) + hypertonic glucose; group C: lactulose as in group A + BS666 as in group B. In terms of patient awakening, BS666 is more efficacious than lactulose which was, nevertheless, efficacious in reversing HE in 62.3% of patients in group A. The best results were observed following the combined use of lactulose and BS666 (gorup C: 100% of patients awoke by the end of treatment) and thus a cumulative effect of the 2 therapeutic measures might be suggested. The BCAA/AAA plasma ratio which was statistically higher in groups B and C with respect to baseline values, appeared to be well correlated with the clinical-neurological evolution of HE. Blood ammonia resulted significantly decreased in these same groups thus suggesting that the BCAA rich mixture employed may also act beneficially on HE through decreasing this "toxic" substance. The decrease, although not statistically significant, in octopamine plasma levels seems to confirm that false neurotransmitters can be somehow involved in the pathogenesis of HE.

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Accession: 004857609

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