scholarly journals Critical Review of Gaps in the Diagnosis and Management of Drug-Induced Liver Injury Associated with Severe Cutaneous Adverse Reactions

2021 ◽  
Vol 10 (22) ◽  
pp. 5317
Author(s):  
Marina Villanueva-Paz ◽  
Hao Niu ◽  
Antonio Segovia-Zafra ◽  
Inmaculada Medina-Caliz ◽  
Judith Sanabria-Cabrera ◽  
...  
Keyword(s):  
Liver Injury ◽  
Adverse Reactions ◽  
Randomized Clinical Trials ◽  
Skin Injury ◽  
Drug Induced ◽  
Cutaneous Manifestations ◽  
Drug Induced Liver Injury ◽  
Complex Disorder ◽  
Cutaneous Adverse Reactions

Drug-induced liver injury (DILI) encompasses the unexpected damage that drugs can cause to the liver. DILI may develop in the context of an immunoallergic syndrome with cutaneous manifestations, which are sometimes severe (SCARs). Nevirapine, allopurinol, anti-epileptics, sulfonamides, and antibiotics are the most frequent culprit drugs for DILI associated with SCARs. Interestingly, alleles HLA-B*58:01 and HLA-A*31:01 are associated with both adverse reactions. However, there is no consensus about the criteria used for the characterization of liver injury in this context, and the different thresholds for DILI definition make it difficult to gain insight into this complex disorder. Moreover, current limitations when evaluating causality in patients with DILI associated with SCARs are related to the plethora of causality assessment methods and the lack of consensual complementary tools. Finally, the management of this condition encompasses the treatment of liver and skin injury. Although the use of immunomodulant agents is accepted for SCARs, their role in treating liver injury remains controversial. Further randomized clinical trials are needed to test their efficacy and safety to address this complex entity. Therefore, this review aims to identify the current gaps in the definition, diagnosis, prognosis, and management of DILI associated with SCARs, proposing different strategies to fill in these gaps.

scholarly journals Role of Ursodeoxycholic Acid in Treating and Preventing Idiosyncratic Drug-Induced Liver Injury. A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Mercedes Robles-Díaz ◽  
Lana Nezic ◽  
Vesna Vujic-Aleksic ◽  
Einar S. Björnsson
Keyword(s):  
Systematic Review ◽  
Liver Injury ◽  
Ursodeoxycholic Acid ◽  
Randomized Clinical Trials ◽  
Case Reports ◽  
Lower Percentage ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Treatment And Prevention

Introduction: Treatment is generally not available for drug-induced liver injury (DILI) patients except in some specific circumstances. The management of DILI is based on the withdrawal of the responsible drug and monitoring the patients and only a few patients need to be referred to a transplant center. Some studies on the role of ursodeoxycholic acid (UDCA) in DILI have been published. The aim of this study was to perform a systematic review of the role of UDCA in the treatment and prevention of DILI.Methods: A search was undertaken in PubMed, with the key words ursodeoxycholic acid, drug-induced liver injury and hepatotoxicity following the PRISMA guidelines.Results: A total of 33 publications were identified: 25 case reports and 8 case series. In 18 of the 25 cases reports (22 patients), authors reported improvement of liver injury associated with UDCA therapy whereas 7 case reports did not show clinical or biochemical improvement after UDCA treatment. There were 4 studies evaluating the role of UDCA in the treatment of DILI, three prospective (one being a clinical trial) and one retrospective studies. Three studies observed liver profile improvements associated with UDCA. In addition, four studies evaluated UDCA in the prevention of DILI: one pilot study, two randomized clinical trials (RCT) and one retrospective study. Three of these studies observed a lower percentage of patients with an increase in transaminases in the groups that used UDCA for DILI prevention.Conclusion: According to available data UDCA seems to have some benefits in the treatment and prevention of DILI. However, the design of the published studies does not allow a firm conclusion to be drawn on the efficacy of UDCA in DILI. A well designed RCT to evaluate the role of UDCA in DILI is needed.

scholarly journals Characterization of patients diagnosed with drug-induced liver injury

2021 ◽  
pp. 036-040
Author(s):  
Ashkenazi Itay ◽  
Lurie Yoav ◽  
Kenig Ariel ◽  
Zevin Shoshana ◽  
Gafanovich Ina ◽  
...  
Keyword(s):  
Liver Injury ◽  
Drug Induced ◽  
Drug Induced Liver Injury

scholarly journals Characterization of primary human hepatocyte spheroids as a model system for drug-induced liver injury, liver function and disease

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Catherine C. Bell ◽  
Delilah F. G. Hendriks ◽  
Sabrina M. L. Moro ◽  
Ewa Ellis ◽  
Joanne Walsh ◽  
...  
Keyword(s):  
Liver Injury ◽  
Liver Function ◽  
Model System ◽  
Human Hepatocyte ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Primary Human Hepatocyte ◽  
Hepatocyte Spheroids

1089 CHARACTERIZATION OF STEROID THERAPY FOR DRUG-INDUCED LIVER INJURY

2020 ◽  
Vol 158 (6) ◽  
pp. S-1304
Author(s):  
Jiayi Ma ◽  
Jiezhun Gu ◽  
Craig Lammert ◽  
Raj Vuppalanchi ◽  
Naga P. Chalasani ◽  
...  
Keyword(s):  
Liver Injury ◽  
Steroid Therapy ◽  
Drug Induced ◽  
Drug Induced Liver Injury

scholarly journals Characterization of primary mouse hepatocyte spheroids as a model system to support investigations of drug-induced liver injury

2021 ◽  
Vol 70 ◽  
pp. 105010
Author(s):  
Manisha Nautiyal ◽  
Rani J. Qasem ◽  
John K. Fallon ◽  
Kristina K. Wolf ◽  
Jingli Liu ◽  
...  
Keyword(s):  
Liver Injury ◽  
Model System ◽  
Drug Induced ◽  
Mouse Hepatocyte ◽  
Drug Induced Liver Injury ◽  
Primary Mouse ◽  
Hepatocyte Spheroids ◽  
Primary Mouse Hepatocyte

scholarly journals Characterization of patients diagnosed with drug-induced liver injury

2020 ◽  
Author(s):  
Itay Ashkenazi ◽  
Yoav Lurie ◽  
Shoshana Zevin ◽  
Ariel Kenig ◽  
Ina Gafanovich ◽  
...  
Keyword(s):  
Liver Injury ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Drug induced cutaneous manifestations due to treatment of gastrointestinal disorders

2020 ◽  
Vol 21 ◽  
Author(s):  
Milica Stojkovic Lalosevic ◽  
Jovan Lalosevic ◽  
Mihailo Stjepanovic ◽  
Marija Stojanovic ◽  
Mirjana Stojkovic
Keyword(s):  
Adverse Reactions ◽  
Skin Lesions ◽  
Gastrointestinal Disorders ◽  
Disease Course ◽  
Drug Induced ◽  
Cutaneous Manifestations ◽  
Therapeutic Modalities ◽  
Common Drug ◽  
Detailed Explanation ◽  
Cutaneous Adverse Reactions

: Cutaneous manifestations due to drugs used in treatment of gastrointestinal disorders are multiple and common. Adequate diagnosis is of great importance, bearing in mind that therapeutic regimen depends on it. In this review we provided an overview of the most common drug-induced skin lesions with a detailed explanation of disease course, presentation and treatment having in mind that in the recent years novel therapeutic modalities have been introduced in treatment of various gastrointestinal disorders, and that incidence of cutaneous adverse reactions has been on the rise.

scholarly journals Phenotypic characterization of idiosyncratic drug-induced liver injury: The influence of age and sex

Hepatology ◽  
2009 ◽  
Vol 49 (6) ◽  
pp. 2001-2009 ◽  
Author(s):  
M. Isabel Lucena ◽  
Raúl J. Andrade ◽  
Neil Kaplowitz ◽  
Miren García-Cortes ◽  
M. Carmen Fernández ◽  
...  
Keyword(s):  
Liver Injury ◽  
Phenotypic Characterization ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Age And Sex
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