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Highlights of drug - and herb- induced liver injury in the literature from 2016: how best to translate new information into clinical practice?

Shahbaz, Omar, Mahajan, Sandeep, Lewis, James H.·2017·Expert Opinion on Drug Metabolism & Toxicology

Abstract

Introduction Over 1500 papers on drug-induced liver injury (DILI) and herb-induced liver injury (HILI) were published in 2016, many of which have the potential to impact clinical practice. Areas covered: Clinical studies and case series that lent themselves to new concepts in diagnosing, and treating DILI were selected for inclusion. Epidemiology of DILI in large prospective registries was highlighted. Causality assessment of drug hepatotoxicity remains challenging, as seen with cases of OxyELITE Pro (OEP). In 2016 updates to the Roussel Uclaf Causality Assessment Method (RUCAM) were published to aid in the accuracy of diagnosing DILI/HILI. New reports of established hepatotoxins were again discussed in 2016, including genetic risk factors for DILI with respect to antituberculous agents. Expert opinion: 2016 marked a turning point in how much credence should be placed in the current causality assessment for DILI/HILI cases. Many recognized hepatotoxins are backed by a relatively few number of literature reports. Danan and Teschke make a strong case that an updated RUCAM should remain the gold standard for diagnosing DILI/HILI going forward, although the role of expert opinion is often still needed in cases where RUCAM falls short. The field of chemoinformatics continues to evolve while we await a truly predictive and diagnostic DILI biomarker.

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Metadata

Authors
Shahbaz, O., Mahajan, S., & Lewis, J. H.
Affiliations
Department of Medicine, Division of Gastroenterology, Hepatology Section, Georgetown University Hospital, Washington, DC, USA
Venue
Expert Opinion on Drug Metabolism & Toxicology
Published
2017-08-28
Volume
13
Issue
9
Pages
935-951
ISSN
  • 1742-5255
  • 1744-7607
Cited by
30
References
3
Language
en

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Shahbaz, O., Mahajan, S., & Lewis, J. H. (2017). Highlights of drug - and herb- induced liver injury in the literature from 2016: how best to translate new information into clinical practice? Expert Opinion on Drug Metabolism & Toxicology. https://doi.org/10.1080/17425255.2017.1362391