RT Journal Article
T1 Definition and risk factors for chronicity following acute idiosyncratic drug-induced liver injury.
A1 Medina-Caliz, Inmaculada
A1 Robles-Diaz, Mercedes
A1 Garcia-Muñoz, Beatriz
A1 Stephens, Camilla
A1 Ortega-Alonso, Aida
A1 Garcia-Cortes, Miren
A1 González-Jimenez, Andres
A1 Sanabria-Cabrera, Judith A
A1 Moreno, Inmaculada
A1 Fernandez, M Carmen
A1 Romero-Gomez, Manuel
A1 Navarro, Jose M
A1 Barriocanal, Ana M
A1 Montane, Eva
A1 Hallal, Hacibe
A1 Blanco, Sonia
A1 Soriano, German
A1 Roman, Eva M
A1 Gomez-Dominguez, Elena
A1 Castiella, Agustin
A1 Zapata, Eva M
A1 Jimenez-Perez, Miguel
A1 Moreno, Jose M
A1 Aldea-Perona, Ana
A1 Hernandez-Guerra, Manuel
A1 Prieto, Martin
A1 Zoubek, Miguel E
A1 Kaplowitz, Neil
A1 Lucena, M Isabel
A1 Andrade, Raul J
K1 Chronic
K1 Hepatotoxicity
K1 Risk factors
K1 Statins
AB Chronic outcome following acute idiosyncratic drug-induced liver injury (DILI) is not yet defined. This prospective, long-term follow-up study aimed to analyze time to liver enzyme resolutions to establish the best definition and risk factors of DILI chronicity. 298 out of 850 patients in the Spanish DILI registry with no pre-existing disease affecting the liver and follow-up to resolution or ⩾1year were analyzed. Chronicity was defined as abnormal liver biochemistry, imaging test or histology one year after DILI recognition. Out of 298 patients enrolled 273 (92%) resolved ⩽1year from DILI recognition and 25 patients (8%) were chronic. Independent risk factors for chronicity were older age [OR: 1.06, p=0.011], dyslipidemia [OR: 4.26, p=0.04] and severe DILI [OR: 14.22, p=0.005]. Alanine aminotransferase (ALT), alkaline phosphatase (ALP) and total bilirubin (TB) median values were higher in the chronic group during follow-up. Values of ALP and TB >1.1 x upper limit of normal (xULN) and 2.8 xULN respectively, in the second month from DILI onset, were found to predict chronic DILI (p1.1 x upper limit of normal (xULN) and 2.8 xULN respectively, in the second month from DILI onset, were found to predict chronic DILI (p One year is the best cut-off point to define chronic DILI or prolonged recovery, with risk factors being older age, dyslipidemia and severity of the acute episode. Statins are distinctly related to chronicity. ALP and TB values in the second month could help predict chronicity or very prolonged recovery. Drug-induced liver injury (DILI) patients who do not resolve their liver damage during the first year should be considered chronic DILI patients. Risk factors for DILI chronicity are older age, dyslipidemia and severity of the acute episode. Chronic DILI is not a very common condition; normally featuring mild liver profile abnormalities and not being an important clinical problem, with the exception of a small number of cases of early onset cirrhosis.
PB Elsevier
YR 2016
FD 2016-05-13
LK http://hdl.handle.net/10668/10089
UL http://hdl.handle.net/10668/10089
LA en
NO Medina-Caliz I, Robles-Diaz M, Garcia-Muñoz B, Stephens C, Ortega-Alonso A, Garcia-Cortes M, et al. Definition and risk factors for chronicity following acute idiosyncratic drug-induced liver injury. J Hepatol. 2016 Sep;65(3):532-42
NO The present study has been supported by grants from the Instituto de Salud Carlos III co-funded by the European Regional Development Fund–FEDER (contract numbers: PI04/1688, PI12-00620, AC-0073-2013) and by the Agencia Española del Medicamento. CIBERehd is funded by the Instituto de Salud Carlos III.
DS RISalud
RD Apr 17, 2025