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Drug-induced liver injury in older people

Lucena, M Isabel, Sanabria, Judith, García-Cortes, Miren, Stephens, Camilla, Andrade, Raúl J·2020·The Lancet Gastroenterology & Hepatology
DOI 10.1016/s2468-1253(20)30006-6
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Abstract

Drug-induced liver injury (DILI) is a rare, unpredictable, and potentially serious adverse reaction. It is induced by many drugs, herbs, and dietary supplements and represents a diagnostic challenge to clinicians. Older people (aged 65 years and older) are often polymedicated, and their declining physiological function affects drug pharmacokinetics. There is no consistent evidence that age is a general risk factor for DILI; however, age might be a risk factor with specific medications, with antimicrobials and cardiovascular drugs being the most likely medications to cause DILI in older people. Ageing influences DILI phenotypes, making cholestatic damage and chronic DILI more likely. In older people with DILI, comorbidities act as confounding causes and account for higher mortality unrelated to the liver. There are no specific therapies for DILI and supportive measures are still the mainstay of management. This Review highlights current advances and gaps in DILI epidemiology, mechanisms, and diagnosis that are pertinent to older individuals.

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Crossref · 10.1016/s2468-1253(20)30006-6

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  • Older age is associated with an increased risk of liver injury induced by isoniazid, amoxicillin-clavulanate, and nitrofurantoin.

    “However, older age is associated with an increased risk of liver injury induced by isoniazid, amoxicillin-clavulanate, and nitrofurantoin [38][39][40].”

    From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [38]

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Metadata

Authors
Lucena, M. I., Sanabria, J., García-Cortes, M., Stephens, C., & Andrade, R. J.
Venue
The Lancet Gastroenterology & Hepatology
Publisher
Elsevier BV
Published
2020-09
Volume
5
Issue
9
Pages
862-874
ISSN
2468-1253
DOI
10.1016/s2468-1253(20)30006-6
Cited by
77
References
9
Language
en
Licence
Funders
  • European Regional Development Fund (PI 18_01804, PT17/0017/0020)
  • Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas
  • Federación Española de Enfermedades Raras
  • Instituto de Salud Carlos III

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