Causality assessment of herb-induced liver injury using multidisciplinary approach and Roussel Uclaf Causality Assessment Method (RUCAM)

Starting as early as 2006 with an analysis from Hong Kong, an overall 21 reports of HILI cases were published which had been assessed for causality using RUCAM with results presented by groups with first authors having their working place in mainland China, Hong Kong, or Taiwan.

“Starting as early as 2006 with an analysis from Hong Kong,18 an overall 21 reports of HILI cases were published which had been assessed for causality using RUCAM with results presented by groups with first authors having their working place in mainland China, Hong Kong, or Taiwan.18–38”

Chau et al. reported that the interrater agreement between experts and RUCAM was 81%.

“As outlined in the report of Chau et al.,20 the interrater agreement between experts and RUCAM was 81%, facilitating evaluations and exclusion of cases with alternative causes or unclear herbal product identification.”

There is now increasing awareness of the benefits provided by RUCAM among various countries, including China, Korea, and Singapore, as evidenced by reports initially published in 2004 from Korea and in 2006 from China and Singapore, with subsequent articles.

“There is now increasing awareness of the benefits provided by RUCAM among various countries, including China,18–38 Korea,40–54 and Singapore,55,56 as evidenced by reports initially published in 2004 from Korea40 and in 2006 from China18 and Singapore,55 with subsequent articles (Table 1).”

On top among the Asian countries is currently China, best explained by the large population and heavy use of herbal traditional Chinese medicines, with increasing numbers of publications and cases until 2019.

“On top among the Asian countries is currently China, best explained by the large population and heavy use of herbal traditional Chinese medicines (TCMs), with increasing numbers of publications and cases until 2019.18–38”