Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines

Devarbhavi, Harshad; Aithal, Guruprasad; Treeprasertsuk, Sombat; Takikawa, Hajime; Mao, Yimin; Shasthry, Saggere M.; Hamid, Saeed; Tan, Soek Siam; Philips, Cyriac Abby; George, Jacob; Jafri, Wasim; Sarin, Shiv K.; on behalf of the Asia Pacific Association of Study of Liver

doi:10.1007/s12072-021-10144-3

Cited by 182Drug-Induced Hepatotoxicity and ProtectionLiver physiology and pathologyDrug-Induced Adverse Reactions

The DOI matches its Crossref record; 185 of the 186 references it cites were found in a registry or an index.

Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines

Devarbhavi, Harshad, Aithal, Guruprasad, Treeprasertsuk, Sombat, Takikawa, Hajime, Mao, Yimin, Shasthry, Saggere M., Hamid, Saeed, Tan, Soek Siam, Philips, Cyriac Abby, George, Jacob, Jafri, Wasim, Sarin, Shiv K., on behalf of the Asia Pacific Association of Study of Liver·2021·Hepatology International

DOI 10.1007/s12072-021-10144-3

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Abstract

Idiosyncratic drug-induced liver injury mimics acute and chronic liver disease. It is under recognized and underrecognised because of the lack of pathognomonic diagnostic serological markers. Its consequences may vary from being asymptomatic to self-limiting illness to severe liver injury leading to acute liver failure. Its incidence is likely to be more common in Asia than other parts of the world, mainly because of hepatotoxicity resulting from the treatment of tuberculosis disease and the ubiquitous use of traditional and complimentary medicines in Asian countries. This APASL consensus guidelines on DILI is a concise account of the various aspects including current evidence-based information on DILI with special emphasis on DILI due to antituberculosis agents and traditional and complementary medicine use in Asia.

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The lack of a reliable diagnostic biomarker and evidence-based treatment paradigm has resulted in limited guidance on how to manage DI-ALH.
“The lack of a reliable diagnostic biomarker and evidence-based treatment paradigm has resulted in limited guidance on how to manage this aspect of DILI.”
From Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report (2023) · cites this paper as [25]
The lack of reliable diagnostic biomarkers and an evidence-based treatment paradigm has resulted in limited guidance on how to manage this aspect of DILI.
“The lack of reliable diagnostic biomarkers and an evidence-based treatment paradigm has resulted in limited guidance on how to manage this aspect of DILI.2,25–27”
From Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis (DI-ALH): An expert opinion meeting report (2023) · cites this paper as [25]
RUCAM is the most widely used tool for causality assessment in DILI.
“Although there are some ambiguities regarding how to score certain sections as well as suboptimal reliability, RUCAM can provide systematic and framed guidance for the assessment of patients with suspected DILI and is the most widely used tool [26,27,51,59].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [59]
RUCAM can provide systematic and framed guidance for the assessment of patients with suspected DILI.
“Although there are some ambiguities regarding how to score certain sections as well as suboptimal reliability, RUCAM can provide systematic and framed guidance for the assessment of patients with suspected DILI and is the most widely used tool [26,27,51,59].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [59]
HDS-DILI in Asia is mainly associated with HMs, termed HILI.
“HDS-DILI in Asia is mainly associated with HMs, termed HILI [59].”
From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [59]

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Authors: Devarbhavi, H., Aithal, G., Treeprasertsuk, S., Takikawa, H., Mao, Y., Shasthry, S. M., Hamid, S., Tan, S. S., Philips, C. A., George, J., Jafri, W., Sarin, S. K., & on behalf of the Asia Pacific Association of Study of Liver
Affiliations: St.John's Medical College Hospital (IN)
Nottingham University Hospitals NHS Trust (GB)
Chulalongkorn University (TH)
Shanghai Jiao Tong University (CN)
Institute of Liver and Biliary Sciences (IN)
Aga Khan University (PK)
Hospital Selayang (MY)
Rajagiri Hospital (IN)
Westmead Hospital (AU)
Corresponding author: Devarbhavi, Harshad
Sarin, Shiv K.
ORCID: Devarbhavi, Harshad
Aithal, Guruprasad
Treeprasertsuk, Sombat
Takikawa, Hajime
Mao, Yimin
Shasthry, Saggere M.
Hamid, Saeed
Philips, Cyriac Abby
George, Jacob
Jafri, Wasim
Sarin, Shiv K.
Venue: Hepatology International
Publisher: Springer Science and Business Media LLC
Published: 2021-02-27
Volume: 15
Issue: 2
Pages: 258-282
ISSN: 1936-0533 (ISSN-L)
1936-0541
DOI: 10.1007/s12072-021-10144-3
OpenAlex: W3134027277
Cited by: 181
References: 186
Citations by year: 2026: 33 · 2025: 45 · 2024: 43 · 2023: 26 · 2022: 24 · 2021: 10
FWCI: 15.35
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Hepatology International (publishedVersion)
PubMed (publishedVersion)
eCommons - AKU (Aga Khan University) (submittedVersion)
Institutional Repositories DataBase (IRDB) (submittedVersion)
Topics: Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
Health Sciences › Medicine › Hepatology › Liver physiology and pathology
Health Sciences › Medicine › Pharmacology (medical) › Drug-Induced Adverse Reactions
Keywords: drug-induced liver injury, idiosyncratic drug-induced liver injury, antitubercular agents, traditional and complementary medicine, hepatotoxicity, acute liver failure
MeSH terms: Asia, Humans, Incidence, Liver Failure, Acute, Chemical and Drug Induced Liver Injury

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Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines

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