Drug & Device Development

BCAAs won't prevent recurrent hepatic encephalopathy

Last Updated: 2011-03-15 16:30:28 -0400 (Reuters Health)

By David Douglas

NEW YORK (Reuters Health) - Branched-chain amino acid supplements won't protect cirrhotic patients from recurrent encephalopathy, Spanish researchers report.

"The main result of the study is that the capacity of nutritional intervention to modify the outcome of advanced cirrhosis is small," senior author Dr. Juan Cordoba told Reuters Health by email. "Supplementing the diet with branched chain amino acids did not significantly decrease the recurrence of hepatic encephalopathy."

But the results don't invalidate previous findings that BCAAs are useful in less advanced cirrhosis or chronic hepatic encephalopathy, he added.

As reported online February 15th in the American Journal of Gastroenterology, Dr. Cordoba of Hospital Vall d'Hebron, Barcelona, and colleagues studied 116 patients who were on a standard low-protein diet following an episode of hepatic encephalopathy: 35 kcal/kg/day and 0.7 g protein/kg/day.

The research team randomly assigned them to receive either BCAA or maltodextrin. Seventeen patients died and 27 received liver transplants. In all, 48 patients completed the study.

Dr. Cordoba admits his results "could be limited by insufficient sample size."

But over 56 weeks, the actuarial rate of freedom from hepatic encephalopathy did not significantly differ between the BCAA and maltodextrin groups (47% vs 33%).

BCAA did improve performance on neuropsychological exams, "but this effect did not result in changes in quality of life, challenging the relevance of mild improvements in psychometric tests," Dr. Cordoba said.

SOURCE: http://bit.ly/i4Fnni

Am J Gastroenterol 2011.