S2619 Use of L-Ornithine L-Aspartate in Reducing Inpatient Hospital Length of Stay in Patients With Hepatic Encephalopathy: A Systematic Review and Meta-Analysis

Introduction: The efficacy of L-Ornithine L-Aspartate (LOLA) therapy in cirrhotic patients hospitalized for hepatic encephalopathy (HE) remains limited in evidence. This systematic review and meta-analysis aimed to evaluate whether LOLA therapy, compared to placebo, reduces the hospital length of stay (LOS) in these patients. Methods: A systematic review and meta-analysis were conducted by screening 257 studies from 2 comprehensive online databases (Medline and Cochrane Library). Two independent investigators assessed abstracts for inclusion criteria. Ten studies underwent detailed review, and 3 met inclusion criteria for evaluating the effect of LOLA therapy on hospital LOS compared to placebo. Results: A total of 413 patients were included across the 3 studies, with 208 patients receiving intravenous LOLA therapy and 205 receiving placebo. A random-effects meta-analysis was performed to assess the difference in hospital LOS between the 2 groups. The pooled mean difference was −2.21 days (95% CI: −4.97, 0.55), suggesting a trend toward shorter stays with LOLA therapy, though this was not statistically significant (z = −1.57, P = 0.116). Substantial heterogeneity was observed (I² = 83.35%, τ² = 4.77), with significant variability between studies (Q(2) = 13.64, P = 0.001). These findings indicate potential reductions in hospital LOS but highlight variability that limits the certainty of the effect. Conclusion: LOLA therapy shows a potential trend toward reducing hospital LOS in cirrhotic patients admitted for HE. However, the results were not statistically significant, and substantial heterogeneity limits definitive conclusions. Further robust, large-scale studies are warranted to confirm whether LOLA can effectively reduce LOS in these patients.