Outcome of acute idiosyncratic drug-induced liver injury: Long-term follow-up in a hepatotoxicity registry
Open accessAbstract
A chronic adverse reaction may occur in some instances of drug-induced liver injury (DILI), even despite drug cessation. In our study, we obtained records from a Spanish registry and evaluated cases of DILI with biochemical evidence of long-term damage. Chronic outcome was defined as a persistent biochemical abnormality of hepatocellular pattern of damage more than 3 months after drug withdrawal or more than 6 months after cholestatic/mixed damage. Data on 28 patients with a chronic clinical evolution (mean follow-up 20 months) between November 1995 and October 2005 were retrieved (18 female; overall mean age 55 yr) and accounted for 5.7% of total idiosyncratic DILI cases (n = 493) submitted to the registry. The main drug classes were cardiovascular and central nervous system (28.5% and 25%, respectively), which, in contrast, represented only 9.8% and 13%, respectively, of all DILI cases. The most frequent causative drugs were amoxicillin–clavulanate (4 of 69 cases), bentazepam (3 of 7 cases), atorvastatin (2 of 7 cases), and captopril (2 of 5 cases). Patients with cholestatic/mixed injury (18 of 194 cases [9%]) were more prone to chronicity than patients with hepatocellular injury (10 of 240 cases; P < .031). In the case of chronic hepatocellular injury, 3 patients progressed to cirrhosis and 2 to chronic hepatitis. In the cholestatic/mixed group, liver biopsy indicated cirrhosis in 1 patient and ductal lesions in 3 patients. In conclusion , cholestatic/mixed type of damage is more prone to become chronic while, in the hepatocellular pattern, the severity is greater. Cardiovascular and central nervous system drugs are the main groups leading to chronic liver damage.
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- Authors
- Andrade, R. J., Lucena, I. M., Kaplowitz, N., García-Muņoz, B., Borraz, Y., Pachkoria, K., García-Cortés, M., Fernández, C. M., Pelaez, G., Rodrigo, L., Durán, J. A., Costa, J., Planas, R., Barriocanal, A., Guarner, C., Romero-Gomez, M., Muņoz-Yagüe, T., Salmerón, J., & Hidalgo, R.
- Affiliations
- Hospital Clínico Universitario Virgen de la Victoria (ES)
- University of Southern California (US)
- Universidad de Málaga (ES)
- Complejo Hospitalario Torrecárdenas (ES)
- Hospital Universitari Germans Trias i Pujol (ES)
- Hospital de Sant Pau (ES)
- Corresponding author
- Andrade, Raúl J.
- ORCID
- Venue
- Hepatology
- Published
- 2006-12
- Volume
- 44
- Issue
- 6
- Pages
- 1581-1588
- ISSN
- 0270-9139 (ISSN-L)
- OpenAlex
- W2168538436
- Cited by
- 309
- References
- 21
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 12 · 2023: 13 · 2022: 13 · 2021: 16 · 2020: 18 · 2019: 16 · 2018: 18 · 2017: 15 · 2016: 21 · 2015: 17 · 2014: 18 · 2013: 21 · 2012: 17
- FWCI
- 13.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Pharmacology › Drug-Induced Adverse Reactions
- Keywords
- idiosyncratic drug-induced liver injury, chronic liver injury, long-term follow-up, cholestatic liver injury, hepatocyte injury, liver cirrhosis, cardiovascular drugs, central nervous system drugs, amoxicillin-clavulanic acid, atorvastatin, captopril
- MeSH terms
- Atorvastatin, Adult, Aged, Aged, 80 and over, Azepines, Captopril, Cardiovascular Agents, Central Nervous System Agents, Chronic Disease, Female, Follow-Up Studies, Heptanoic Acids, Humans, Liver, Liver Diseases, Male, Middle Aged, Pyrroles, Registries, Spain, Disease Progression, Amoxicillin-Potassium Clavulanate Combination, Chemical and Drug Induced Liver Injury, Drug-Related Side Effects and Adverse Reactions
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