Branched-Chain Amino Acid Supplements Did Not Reduce Recurrence of Hepatic Encephalopathy

The mainstay of treatment for hepatic encephalopathy (HE), a common complication of cirrhosis, has included medications such as lactulose and, more recently, rifaximin. Nutritional therapy with protein restriction has also been used because a protein load can increase plasma ammonia. However, restricting the amount of protein might lead to protein malnutrition. Moreover, it has been postulated that the type of protein could matter: Aromatic amino acids might precipitate HE whereas branched-chain amino acids (BCAA) might improve cognitive function.

To assess whether BCAA supplementation could reduce recurrence of HE, researchers in Spain conducted a randomized, double-blind, multicenter study involving 116 patients who had been hospitalized w…