2026-04-17T04:04:33Zhttps://recercat.cat/oai/request

oai:recercat.cat:2072/4273582026-03-28T05:11:26Zcom_2072_98col_2072_378192

00925njm 22002777a 4500 dc Ventura-Cots, Meritxell author Concepción, Mar author Arranz-Amo, Jose Antonio author Simón Talero, Macarena author Torrens, Maria author Blanco-Grau, Albert author Fuentes Camps, Inmaculada author Suñé, Pilar author Alvarado-Tapias, Edilmar author Gely, Cristina author Roman, Eva author Mínguez Rosique, Beatriz author Soriano, German author Genescà Ferrer, Joan author Córdoba Cardona, Juan author Universitat Autònoma de Barcelona author 2016 Ornithine phenylacetate (OP) has been proven effective in lowering ammonia plasma levels in animals, and to be well tolerated in cirrhotic patients. A trial to assess OP efficacy in lowering plasma ammonia levels versus placebo in cirrhotic patients after an upper gastrointestinal bleeding was performed. The primary outcome was a decrease in venous plasma ammonia at 24 hours. A total of 38 consecutive cirrhotic patients were enrolled within 24 hours of an upper gastrointestinal bleed. Patients were randomized (1:1) to receive OP (10 g/day) or glucosaline for 5 days. The primary outcome was not achieved. A progressive decrease in ammonia was observed in both groups, being slightly greater in the OP group, with significant differences only at 120 hours. The subanalysis according to Child-Pugh score showed a statistically significant ammonia decrease in Child-Pugh C-treated patients at 36 hours, as well as in the time-normalized area under the curve (TN-AUC) 0-120 hours in the OP group [40.16 μmol/l (37.7-42.6); median (interquartile range) (IQR)] versus placebo group [65.5 μmol/l (54-126); p = 0.036]. A decrease in plasma glutamine levels was observed in the treated group compared with the placebo group, and was associated with the appearance of phenylacetylglutamine in urine. Adverse-event frequency was similar in both groups. No differences in hepatic encephalopathy incidence were observed. OP failed to significantly decrease plasma ammonia at the given doses (10 g/day). Higher doses of OP might be required in Child-Pugh A and B patients. OP appeared well tolerated. Ammonia Cirrhosis Hepatic encephalopathy Ornithine phenylacetate Upper gastrointestinal bleeding Impact of ornithine phenylacetate (OCR-002) in lowering plasma ammonia after upper gastrointestinal bleeding in cirrhotic patients