 LOLA has been used for many years for the treatment of HE in cirrhosis of the liver, especially minimal and overt chronic low grade HE. The clinical efficacy of LOLA has already been comprehensively investigated and reported in therapeutic observations, clinical trials 16, 18-25 and meta-analysis 26,27. In these studies, the use of LOLA as infusion, oral administration or a combination of the two, was documented in patients with mild to severe liver insufficiency. LOLA showed a statistically significant effect with respect to an improvement in mental state reduction in the HE grade, increased detoxification reduction of the ammonia concentration in the blood and positive effects on psychomotor function reduction of time required in the number connection test in Minimal Hepatic Encephalopathy and overt chronic Grade I-II Hepatic Encephalopathy, and acute overt HE. With these findings, evidence-based medicine criteria for demonstrating efficacy have been fulfilled. 