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Hepatobiliary and pancreatic: Comparison between Chinese herbal medicine and Western medicine-induced liver injury of 1985 patients
Abstract
Background and Aim: Chinese herbal medicine (CHM), as well as Western medicine (WM), is an important cause of drug‐induced liver injury (DILI). However, the differences between CHM and WM as agents implicated in liver injury have rarely been reported. Methods: Overall, 1985 (2.05%) DILI cases were retrospectively collected from the 96 857 patients hospitalized because of liver dysfunction in the 302 Military Hospital between January 2009 and January 2014. Results: In all the enrolled patients with DILI, CHM was implicated in 563 cases (28.4%), while 870 cases (43.8%) were caused by WM and the remaining patients (27.8%) by the combination of WM and CHM. Polygonum multiflorum was the major implicated CHM. Compared with WM, the cases caused by CHM showed more female (51 vs 71%, P < 0.001) and positive rechallenge (6.1 vs 8.9%, P = 0.046), a much greater proportion of hepatocellular injury (62.2 vs 88.5%, P < 0.001), and a higher mortality (2.8 vs 4.8%, P = 0.042); however, no differences in the rates of chronic DILI and ALF were found (12.9 vs 12.4%, P = 0.807; 7.6 vs 7.6%, P = 0.971). Based on Roussel Uclaf Causality Assessment Method, 75.6% of cases caused by CHM were classified as probable and only 16.6% as highly probable, significantly different from WM (38.4 and 60.3%, all P < 0.001). Conclusions: The causal relationship between CHM and liver injury is much complex, and the clinical characteristics of DILI caused by CHM differ from those caused by WM.
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Few reports combined results of both HILI and DILI cases, causing confusion due to mixed data.
“but few combined results of both HILI and DILI cases, causing confusion due to mixed data.24,26,30,36”
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 [30]
Some studies included HILI cases not only with highly probable or probable causality gradings but also with a possible causality level based on RUCAM scores ≥3.
“Some studies included HILI cases not only with highly probable or probable causality gradings but also with a possible causality level based on RUCAM scores ≥3 (Table 1).24,25,27,28,30,36,38”
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 [30]
Citations
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Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network
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Cited by
Sorted by citations
Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines
Devarbhavi, H., Aithal, G., Treeprasertsuk, S., Takikawa, H., Mao, Y., Shasthry, S. M., Hamid, S., Tan, S. S., Philips, C. A., George, J., et al. (2021) · Hepatology International · doi:10.1007/s12072-021-10144-3 · Cited by 181
Teschke, R., Zhu, Y., & Jing, J. (2020) · Journal of Clinical and Translational Hepatology · doi:10.14218/jcth.2020.00009 · Cited by 41
Self-citationCharacteristics of Drug-Induced Liver Injury in Northeast China: Disease Spectrum and Drug Types
Zhang, C., Wu, Y., Yuan, S., Dou, X., Sheng, Q., Wang, J., Tian, W., Yao, L., & Ding, Y. (2020) · Digestive Diseases and Sciences · doi:10.1007/s10620-019-06030-6 · Cited by 6
Self-citation
Metadata
- Authors
- Zhu, Y., Niu, M., Chen, J., Zou, Z., Ma, Z., Liu, S., Wang, R., He, T., Song, H., Wang, Z., Pu, S., Ma, X., Wang, L., Bai, Z., Zhao, Y., Li, Y., Wang, J., Xiao, X., & on behalf of The Specialized Committee for Drug‐Induced Liver Diseases, D. O. D. D.
- Affiliations
- China Military Institute of Chinese Medicine 302 Military Hospital Beijing China
- Diagnosis and Treatment Center for Non‐infectious Diseases 302 Military Hospital Beijing China
- Department of Pathology 302 Military Hospital Beijing China
- Department of traditional Chinese medicine 302 Military Hospital Beijing China
- Integrative Medical Center 302 Military Hospital Beijing China
- Center for Drug Reevaluation China Food and Drug Administration Beijing China
- Venue
- Journal of Gastroenterology and Hepatology
- Publisher
- Wiley
- Published
- 2016-08
- Volume
- 31
- Issue
- 8
- Pages
- 1476-1482
- ISSN
- 0815-9319
- 1440-1746
- Cited by
- 86
- References
- 2
- Language
- en
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