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Hepatic Encephalopathy 

Hepatic Encephalopathy (HE) is a serious condition in which the liver is severely damaged, leading to loss of brain function. HE is the result of acute liver failure, cirrhosis, or chronic liver disease.

A healthy functioning liver filters out the harmful materials sent from the intestines and prevents them from entering the blood stream. These toxins are either produced naturally in the body or may come from foreign substances such as food or medication. When the liver can no longer filter out these toxins, they end up in the blood stream and affect brain functionality. 

Symptoms of hepatic encephalopathy vary in both severity and speed of deterioration. Early symptoms may include:

  • Changes in sleep patterns
  • Mild confusion
  • Difficulty thinking
  • Problems with handwriting
  • Forgetfulness
  • Poor judgment or concentration

More severe symptoms can include:

  • Tremor or abnormal movements
  • Severe confusion
  • Slurred speech
  • Slowed movement
  • Seizures
  • Severe personality changes
  • Coma

People with hepatic encephalopathy can become unconscious or unresponsive. Some patients with HE are unable to care for themselves because of their symptoms. 

In some cases, hepatic encephalopathy is a short-term problem that can be corrected if treated early. However, it can also be part of a chronic effect of liver disease that worsens over time. It is important that patients discover and address the cause of their liver damage in order to prevent or slow the progression of HE.

A lot of the medications available used to treat HE focus on slowing the rate at which your body produces and absorbs toxins. Researchers and scientists are searching for other medications to help aid in the treatment and and recovery of HE. 

If you or someone you know is suffering from Hepatic encephalopathy, please talk with one of our doctors about available treatment options. We also often have clinical trials that may help when these options do not. 

At Vanderbilt's GI Clinical Trials Enterprise, we are dedicated to finding a solution that works for you.

Current Trials for Hepatic Encephalopathy 

Title: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial To Evaluate The Efficacy, Safety, And Pharmacokinetics Of Rifaximin 550 Mg In Subjects With Severe Hepatic Impairment And Overt Hepatic Encephalopathy; (RFHE4043)

Study Contact: Melanie Dean 615-936-1745

Principal Investigator: Michael Porayko, MD

The purpose of the study is to evaluate the safety of Rifaximin or placebo in subjects with severe hepatic impairment and Hepatic Encephalopathy.

Click here to learn more about this study


Title: Phase 2B Efficacy/Safety of Ornithine Phenylacetate in Hospitalized Cirrhotic Patients With Hepatic Encephalopathy

Study Contact: Melanie Dean 615-936-1745

Principal Investigator: Michael Porayko, MD

This is a multicenter, randomized, double-blind, placebo-controlled study of ornithine phenylacetate (OCR-002) administered intravenously to hospitalized patients with cirrhosis, hyperammonemia, and an acute episode of hepatic encephalopathy administered on top of standard of care treatment.


Click here to learn more about this study