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We are conducting a phase 4 randomised, placebo-controlled drug trial of L-ornithine L-aspartate (LoLA) therapy. The protocol comprises a longitudinal 3-month investigation of brain and muscle function of 34 subjects with established cirrhosis and minimal hepatic encephalopathy (MHE) at three-time points (baseline, week 4 and week 12). We are investigating the hypothesis that LoLA is thought to improve brain function by increasing nitrogen elimination in the liver (thereby reducing hyperammonaemia in these patients) and reduce sarcopenia by promoting glutamine uptake peripherally.  The effects of this treatment on brain function are being investigated by advanced MRI.

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