Kratom (Mitragyna Speciosa) Liver Injury: A Comprehensive Review

Schimmel, Jonathan; Dart, Richard C.

doi:10.1007/s40265-019-01242-6

Cited by 50 publications

(44 citation statements)

References 64 publications

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“…Other sources providing RUCAM based HILI cases include the Chinese Academy of Medical Sciences in Beijing [ 195 ], School of Chinese Materia Medica in Beijing [ 199 , 202 ], Competence Centre for Complementary Medicine and Naturopathy in Munich [ 211 ], Biomedical Research and Innovation Platform South African Medical Research Council in Tygerberg [ 239 ], United States Pharmacopeia in Rockville [ 254 ], and Center of Pharmacovigilance of Florence [ 218 ].…”

Section: Worldwide Publications Of Hili Cases Assessed For Causalimentioning

confidence: 99%

“…With 11,609 the largest HILI case number was published in 2019 ( Figure 3 ) as a consequence of the ongoing worldwide use of RUCAM for assessing causality in suspected HILI cases ( Table 4 ). In particular, contributing countries were in alphabetical order Australia [ 29 ], Brazil [ 183 ], China [ 48 , 196 , 197 , 198 , 199 , 200 , 201 ], Germany [ 213 , 214 , 215 ], India [ 217 ], Italy [ 222 ], Korea [ 103 ], Spain [ 115 , 117 , 240 , 241 , 242 ], Switzerland [ 244 ], and the US [ 245 , 246 , 247 , 248 , 249 , 250 , 251 , 252 , 253 , 254 ]. Most of the 11,619 HILI cases published in 2019 were from China [ 48 , 196 ] and Korea [ 103 ], with 6971 cases published by Shen et al [ 48 ], 2019 cases reported by Byeon et al [ 103 ], and 1552 cases provided by Chow et al [ 196 ].…”

Section: Worldwide Publications Of Hili Cases Assessed For Causalimentioning

confidence: 99%

“…Most of the 11,619 HILI cases published in 2019 were from China [ 48 , 196 ] and Korea [ 103 ], with 6971 cases published by Shen et al [ 48 ], 2019 cases reported by Byeon et al [ 103 ], and 1552 cases provided by Chow et al [ 196 ]. However, until mid 2020 only 57 HILI cases were published ( Table 4 ) [ 202 , 203 , 253 , 254 ], suggesting for the whole year 2020 at best 100 cases ( Figure 3 ).…”

Section: Worldwide Publications Of Hili Cases Assessed For Causalimentioning

confidence: 99%

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Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993–Mid 2020: A Comprehensive Analysis

Teschke

Danan²

2020

Medicines

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Background: A large number of idiosyncratic drug induced liver injury (iDILI) and herb induced liver injury(HILI) cases of variable quality has been published but some are a matter of concern if the cases were not evaluated for causality using a robust causality assessment method (CAM) such as RUCAM (Roussel Uclaf Causality Assessment Method) as diagnostiinjuryc algorithm. The purpose of this analysis was to evaluate the worldwide use of RUCAM in iDILI and HILI cases. Methods: The PubMed database (1993–30 June 2020) was searched for articles by using the following key terms: Roussel Uclaf Causality Assessment Method; RUCAM; Idiosyncratic drug induced liver injury; iDILI; Herb induced liver injury; HILI. Results: Considering reports published worldwide since 1993, our analysis showed the use of RUCAM for causality assessment in 95,885 cases of liver injury including 81,856 cases of idiosyncratic DILI and 14,029 cases of HILI. Among the top countries providing RUCAM based DILI cases were, in decreasing order, China, the US, Germany, Korea, and Italy, with China, Korea, Germany, India, and the US as the top countries for HILI. Conclusion: Since 1993 RUCAM is certainly the most widely used method to assess causality in IDILI and HILI. This should encourage practitioner, experts, and regulatory agencies to use it in order to reinforce their diagnosis and to take sound decisions.

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Section: Worldwide Publications Of Hili Cases Assessed For Causalimentioning

confidence: 99%

Section: Worldwide Publications Of Hili Cases Assessed For Causalimentioning

confidence: 99%

Section: Worldwide Publications Of Hili Cases Assessed For Causalimentioning

confidence: 99%

See 1 more Smart Citation

Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993–Mid 2020: A Comprehensive Analysis

Teschke

Danan²

2020

Medicines

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“…Kratom has been described as a potential self‐treatment for prescription and illicit opioid use disorder, which the FDA considers unsubstantiated [9]. Potential health consequences associated with kratom use include seizure and liver injury, and abstinence may lead to a withdrawal syndrome [11,12]. Reported fatalities have generally been in the setting of concomitant drug use, but post‐mortem analysis has determined a portion of fatalities attributable to kratom alone [2].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and description of kratom (Mitragyna speciosa) use in the United States: a cross‐sectional study

et al. 2020

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Background and aims Mitragyna speciosa (‘kratom’) contains mu opioid partial agonists. It is widely available, and occasionally used as a home remedy for opioid use disorder. The Drug Enforcement Agency considers kratom a drug of concern; however, prevalence of use and role in drug misuse are unknown. This study aimed to characterize kratom use in the United States. Design Cross‐sectional Survey of Non‐Medical Use of Prescription Drugs (NMURx) Program, 2018 third quarter and 2019 first quarter. Setting A validated non‐probability online survey in the United States. Participants A total of 59 714 respondents aged 18 years or older, weighted to represent the adult US population (n = 252 063 800). Measurements In addition to prevalence of past‐year kratom and other drug use, behavior proportions were estimated. The Drug Abuse Screening Test (DAST‐10) estimated consequences of drug abuse. Findings The estimated prevalence of past‐year kratom use in the adult US population was 0.8% [95% confidence interval (CI) = 0.7–0.9], representing 2 031 803 adults. Life‐time prevalence was 1.3% (95% CI = 1.2–1.4), representing 3 353 624 adults. Kratom users were younger (mean 35 years, P < 0.001), with higher proportions of males (61.0 versus 48.6%, P < 0.001), students (14.1 versus 7.5%, P < 0.001) and health‐care professionals (9.7 versus 4.5%, P < 0.001) and fewer bachelor's/advanced degree graduates (33.4 versus 42.6%, P < 0.001) compared with non‐users. Results were inconclusive on whether there was a difference in kratom use by race, household income or employment status. Among those with past‐year kratom use, 36.7% (95% CI = 32.1–41.3) non‐medically used prescription opioids, 21.7% (95% CI = 18.0–25.5) used illicit opioids, 54.4% (95% CI = 49.5–59.3) used another illicit drug and 67.1% (95% CI = 62.5–71.8) used cannabis. The DAST‐10 profile was more often substantial/severe in kratom users (21 versus 1%, P < 0.001) compared with non‐users. Conclusions Estimated United States past‐year prevalence of kratom use is 0.8%, and kratom users tend to have more serious substance abuse profiles than non‐users or users of cannabis, alcohol or cigarettes. To our knowledge, this is the first description of kratom use at the national level.

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“…Despite the potential therapeutic benefit, kratom has also severe side effects, that should be always considered when suggesting or only considering a treatment with kratom (35). Among the most severe side effects have been described kratom associated hepatitis (36)(37)(38)(39), seizures and coma (40,41), hypogonadism (42), hypothyroidism (43), posterior reversible leukoencephalopathy (44), fatalities (29,45) and overdoses (46,47). It is important to underlie, however that most of these events were described mainly in the US and Europe (where Kratom was recently introduced), with a majority of the reported deaths involving the presence of other substances (29), such as benzodiazepine, opioids, antidepressant or antipsychotic agents, alcohol or other substances, e.g., Datura stramonium, cannabinoids, amphetamines (40,45,(48)(49)(50)(51), and other contaminant such as O-desmethyltramadol (52).…”

mentioning

confidence: 99%

Can Kratom (Mitragyna speciosa) Alleviate COVID-19 Pain? A Case Study

et al. 2020

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Among the symptoms of COVID-19 fever, general malaise, pain and aches, myalgia, fatigue, and headache can affect the quality of life of patients, even after the end of the acute phase of the infection and can be long lasting. The current treatment of these symptoms, also because COVID-19 patients have been asked not to use non-steroidal anti-inflammatory drugs (NSAIDs), in particular ibuprofen are often unsatisfactory. Among the above mentioned symptoms malaise and fatigue seem the most difficult to treat. In this case report we describe the use of kratom (Mitragyna speciosa) by a patient with confirmed COVID-19 infection. What we observed was a fast and sustained relieve of the above mentioned symptoms.

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Kratom (Mitragyna Speciosa) Liver Injury: A Comprehensive Review

Cited by 50 publications

References 64 publications

Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993–Mid 2020: A Comprehensive Analysis

Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993–Mid 2020: A Comprehensive Analysis

Prevalence and description of kratom (Mitragyna speciosa) use in the United States: a cross‐sectional study

Can Kratom (Mitragyna speciosa) Alleviate COVID-19 Pain? A Case Study

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