Novel Therapies in Hepatic Encephalopathy

Clin Liver Dis. 2020 May;24(2):303-315. doi: 10.1016/j.cld.2020.01.009. Epub 2020 Mar 2.

Abstract

Despite widespread use of lactulose and rifaximin for the treatment of hepatic encephalopathy, this complication of advanced liver disease remains a major burden on the health care system in the United States and continues to predispose to high morbidity and mortality. Several agents have surfaced over recent years with promise to treat hepatic encephalopathy and mitigate the cognitive impairment associated with this disease process. The purpose of this article is to highlight the leading emerging therapies in hepatic encephalopathy as well as their therapeutic targets.

Keywords: Acetyl-L-carnitine; Ammonia scavengers; Flumazenil; Glycerolphenylbutyrate; Gut; Hepatic encephalopathy; Polyethylene glycol.

Publication types

  • Review

MeSH terms

  • Acetylcarnitine / therapeutic use
  • Albumins / therapeutic use
  • Ammonia / blood
  • Dipeptides / therapeutic use
  • Fecal Microbiota Transplantation*
  • Flumazenil / therapeutic use
  • GABA Modulators / therapeutic use
  • Glycerol / analogs & derivatives
  • Glycerol / therapeutic use
  • Hepatic Encephalopathy / blood
  • Hepatic Encephalopathy / etiology
  • Hepatic Encephalopathy / therapy*
  • Humans
  • Nootropic Agents / therapeutic use
  • Ornithine / analogs & derivatives
  • Ornithine / therapeutic use
  • Phenylbutyrates / therapeutic use
  • Polyethylene Glycols / therapeutic use
  • Probiotics
  • Surface-Active Agents / therapeutic use

Substances

  • Albumins
  • Dipeptides
  • GABA Modulators
  • Nootropic Agents
  • Phenylbutyrates
  • Surface-Active Agents
  • Polyethylene Glycols
  • Flumazenil
  • Acetylcarnitine
  • Ammonia
  • ornithine phenylacetate
  • Ornithine
  • ornithylaspartate
  • Glycerol
  • glycerol phenylbutyrate