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A Prospective Nationwide Study of Drug-Induced Liver Injury in Korea

Suk, Ki Tae, Kim, Dong Joon, Kim, Chang Hoon, Park, Seung Ha, Yoon, Jai Hoon, Kim, Yeon Soo, Baik, Gwang Ho, Kim, Jin Bong, Kweon, Young Oh, Kim, Byung Ik, Kim, Seok Hyun, Kim, In Hee, Kim, Ju Hyun, Nam, Soon Woo, Paik, Yong Han, Suh, Jeong Ill, Sohn, Joo Hyun, Ahn, Byung Min, Um, Soon Ho, Lee, Heon Ju, Cho, Mong, Jang, Myoung Kuk, Choi, Sung Kyu, Hwang, Seong Gyu, Sung, Ho Taik, Choi, Jong Young, Han, Kwang Hyub·2012·American Journal of Gastroenterology
DOI 10.1038/ajg.2012.138
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Abstract

Objectives To address a growing concern about drug-induced liver injury (DILI), a nationwide study was performed to investigate the significance of DILI in Korea. Methods From May 2005 to May 2007, cases of DILI (alanine transferase > 3 × upper normal limit or total bilirubin > 2 × upper normal limit) from 17 referral university hospitals were prospectively enrolled. Adjudication by the seven review boards was considered for the confirmation of causality and the Roussel Uclaf Causality Assessment Method (RUCAM) scale was used. Results A total of 371 cases were diagnosed with DILI. The extrapolated incidence of hospitalization at university hospital in Korea was 12/100,000 persons/year. The causes included "herbal medications" (102, 27.5%), "prescription or non-prescription medications" (101, 27.3%), "health foods or dietary supplements" (51, 13.7%), "medicinal herbs or plants" (35, 9.4%), "folk remedies" (32, 8.6%), "combined" (30, 8.2%), "herbal preparations" (12, 3.2%), and others (8, 2.2%). Nine cases were linked to acetaminophen. The frequencies of hepatocellular, mixed, and cholestatic types were 76.3, 14.8, and 8.9%, respectively. A total of 234 cases met the criteria for Hy's law. Five patients died or underwent transplantation. Twenty-five cases (21 herbs and 4 medications) did not meet the time-to-onset criteria of the RUCAM. Conclusions DILI appears to be a highly relevant health problem in Korea. "Herbal medications" are the principal cause of DILI. A more objectiv…

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  • Suk et al. followed a prospective design for their nationwide HILI study in Korea.

    “Prefect studies were provided among others by Suk et al.,50 who followed a prospective design for their nationwide HILI study in Korea”

    From Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases (2020) · cites this paper as [50]

  • Shortcomings in Korean articles included inclusion of cases with a possible causality grading that impairs focus on cases with a probable or highly probable causality grading.

    “the inclusion of cases with a possible causality grading that impairs the focus on cases with a probable or highly probable causality grading40,41,42,50,52,54”

    From Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases (2020) · cites this paper as [50]

  • Females are suggested to have a higher risk of idiosyncratic DILI than males in many retrospective studies.

    “Though females are suggested to have a higher risk of idiosyncratic DILI than males in many retrospective studies, 8,[27][28][29][30]”

    From Incidence and Etiology of Drug-Induced Liver Injury in Mainland China (2019) · cites this paper as [28]

  • In Asian countries such as South Korea, Malaysia, Thailand, Singapore, Taiwan, India, and China, anti-TB drugs, herbal and alternative medications such as TCM, and antibiotics are the leading causes of DILI.

    “In Asian countries, such as South Korea [7], Malaysia [16], Thailand [17], Singapore [18], Taiwan [19], India [20], and China [8], anti-TB drugs, herbal and alternative medications such as traditional Chinese medicine (TCM), and antibiotics are the leading causes of DILI.”

    From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [7]

  • HMs are the leading cause of DILI in many Asian countries such as Korea, Thailand, and Singapore, accounting for 27.5%, 41.5%, and 61.4% respectively.

    “HMs are the leading cause of DILI in many Asian countries such as Korea [7], Thailand [17], and Singapore [18], and accounts for 27.5%, 41.5%, and 61.4% respectively.”

    From Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update (2024) · cites this paper as [7]

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Research works printed but not linked: 28

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Metadata

Authors
Suk, K. T., Kim, D. J., Kim, C. H., Park, S. H., Yoon, J. H., Kim, Y. S., Baik, G. H., Kim, J. B., Kweon, Y. O., Kim, B. I., Kim, S. H., Kim, I. H., Kim, J. H., Nam, S. W., Paik, Y. H., Suh, J. I., Sohn, J. H., Ahn, B. M., Um, S. H., Lee, H. J., Cho, M., Jang, M. K., Choi, S. K., Hwang, S. G., Sung, H. T., Choi, J. Y., & Han, K. H.
Venue
American Journal of Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-09
Volume
107
Issue
9
Pages
1380-1387
ISSN
0002-9270
DOI
10.1038/ajg.2012.138
Cited by
221
References
0
Language
en
Licence
www.springer.com/tdm (unspecified)

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