Liver enzyme abnormalities in taking traditional herbal medicine in Korea: A retrospective large sample cohort study of musculoskeletal disorder patients

Lee, Jinho; Shin, Joon‐Shik; Kim, Me-riong; Byun, Jang-Hoon; Lee, Seung‐Yeol; Shin, Ye-sle; Kim, Hye-Jin; Park, Ki Byung; Shin, Byung‐Cheul; Lee, Myeong Soo; Ha, In‐Hyuk

doi:10.1016/j.jep.2015.04.048

Cited by 27 publications

(34 citation statements)

References 18 publications

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“…The present result was slightly higher than that of HILI (0.56%, 95% CI [0.07, 1.05]) with 892 patients in a retrospective study(Kim et al, ) and that of HILI (0.43%) with 1169 patients in another retrospective study (Woo et al, ). However, this result was slightly lower than that of HILI (0.60%, 95% CI [0.12, 1.08]) with 1,001 patients in a nationwide prospective study (Cho et al, ) and that of HILI (0.6%) with 4,769 patients in another retrospective study (Lee, Shin, et al, ). These four studies defined the liver injury using the original method (Hayashi, ).…”

Section: Discussionmentioning

confidence: 77%

“…However, this result was slightly lower than that of HILI (0.60%, 95% CI [0.12, 1.08]) with 1,001 patients in a nationwide prospective study (Cho et al, 2017) and that of HILI (0.6%) with 4,769 patients in another retrospective study (Lee, Shin, et al, 2015). These four studies defined the liver injury using the original method (Hayashi, 2016).…”

Section: Incidence Risk Of Lea In Each Rdmentioning

confidence: 90%

“…In particular, herb-induced liver injury (HILI), which has varying incidence from 0% to 1.92% in Korea, has been the topic of debates (Oh et al, 2015;Shahbaz, Mahajan, & Lewis, 2017). Research for HILI on certain diseases includes musculoskeletal disorders, atopic dermatitis, and type 2 diabetes (Lee, Shin, et al, 2015;Tian et al, 2016;Yun et al, 2017). Such studies also need to be performed on RD, because patients with RD are vulnerable to liver injury caused by underlying diseases through autoimmune mechanisms (Ohira, Abe, & Takahashi, 2012) as well as liver-mediated drug metabolism induced by either conventional or herbal medicines with conventional drug-herb interaction (Aithal, 2011;Goossens, Spahr, & Rubbia-Brandt, 2013;Ikeda, 2011;Michna, Duh, Korves, & Dahl, 2010).…”

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confidence: 99%

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Liver enzyme abnormalities of inpatients with rheumatic diseases: A 10‐year retrospective study in a Korean medicine hospital

Lee

Kang

et al. 2018

Phytotherapy Research

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Herbal medicines have been used as a treatment option for rheumatic disease (RD), but they often produce liver enzyme abnormality. This study examines the incidence of herb-induced liver injury (HILI) and the relationship between risk factors and liver enzyme abnormality (LEA) in inpatients with RD. HILI was analyzed using the Roussel Uclaf causality assessment method liver injury criteria and causality assessment. Multivariable analysis was performed to assess the relationship between patient characteristics and LEA in RD. The features of LEA were also examined in each RD. Among 352 patients included in this study, 105 patients showed LEA on admission, of which 6 had fulfilled the Roussel Uclaf causality assessment method criteria. The incidence risks of LEA and HILI were 12.55% and 0.58%, respectively. Multivariable analysis showed that LEA on admission and occasional use of alcohol could be risk factors for LEA on follow-up. In an additional analysis with each RD, all rheumatoid arthritis patients with LEA were taking nonsteroidal anti-inflammatory drugs, steroids, and disease-modifying antirheumatic drugs, and 4 out of 5 gout patients with LEA were taking steroids. The use of herbal medicine in RD is relatively safe. However, regular monitoring of liver enzyme tests and examination of alcohol consumption are required.

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Section: Discussionmentioning

confidence: 77%

Section: Incidence Risk Of Lea In Each Rdmentioning

confidence: 90%

mentioning

confidence: 99%

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Liver enzyme abnormalities of inpatients with rheumatic diseases: A 10‐year retrospective study in a Korean medicine hospital

Lee

Kang

et al. 2018

Phytotherapy Research

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“…First authors of reports from Korea contributed as experts were numbered overall 15, and thereby represented a substantial number of publications on 526 HILI cases that had been assessed for causality using RUCAM (Table 1). [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] These included single case reports, case series and review articles. Respective articles were mostly of good quality, with minor shortcomings.…”

Section: Koreamentioning

confidence: 99%

“…These included, for instance, the use of a RUCAM version modified by the authors for unknown reason(s) without own method re-validation, 40,44,51,53 the inclusion of cases with a possible causality grading that impairs the focus on cases with a probable or highly probable causality grading 40,41,42,50,52,54 using the RUCAM algorithm but leaving individual causality grading unreported for unknown reason(s), 51,54 forgetting quotation of the used RUCAM publication, 51,54 and classifying the original highly probable causality grading erroneously as definite. 47 It seems that most reports followed a retrospective study approach (Table 1), [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] whereas RUCAM instructions clearly recommend the use of RUCAM for prospective studies. 15 Journal of Clinical and Translational Hepatology 2020 vol.…”

Section: Koreamentioning

confidence: 99%

Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases

Teschke¹,

Zhu²,

Jing³

2020

Journal of Clinical and Translational Hepatology

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Herb-induced liver injuries (HILI) by traditional herbal medicines are particular challenges in Asian countries, with issues over the best approach to establish causality. The aim of the current analysis was to provide an overview on how causality was assessed in HILI cases from Asian countries and whether the Roussel Uclaf Causality Assessment Method (RUCAM) was the preferred diagnostic algorithm, as shown before in worldwide evaluated cases of drug-induced liver injury (DILI). Using the PubMed database, publications in English language were preferred to allow for reevaluation by peers. Overall 11,160 HILI cases have assessed causality using RUCAM and were published by first authors working in Asian countries. With 21 evaluable reports, most publications came from mainland China, with Hong Kong and Taiwan, followed by Korea (n=15), Singapore (n=2), and Japan (n=1), while other Asian countries were not contributory. Most publications provided case and RUCAM data of good quality. For better presentation of future cases, however, the following recommendations are given: (1) preference of prospective study design with use of the updated RUCAM version; (2) clear separation of HILI cohorts from those of other herbal products or DILI; (3) case series for epidemiology studies should contain many essential data, possibly also as supplementary material; (4) otherwise, preference of single case reports providing individual case data and RUCAM-based causality gradings, and applying liver test threshold values; and (5) publication in English language journals. In conclusion, China and Korea are top in presenting RUCAM-based HILI cases, other Asian countries are encouraged to follow.

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Effectiveness and safety of Korean medicine for pain management after musculoskeletal surgery: a retrospective study

Lee

Kim²,

Kim³

et al. 2022

ADV TRADIT MED (ADTM)

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Liver enzyme abnormalities in taking traditional herbal medicine in Korea: A retrospective large sample cohort study of musculoskeletal disorder patients

Cited by 27 publications

References 18 publications

Liver enzyme abnormalities of inpatients with rheumatic diseases: A 10‐year retrospective study in a Korean medicine hospital

Liver enzyme abnormalities of inpatients with rheumatic diseases: A 10‐year retrospective study in a Korean medicine hospital

Herb-induced Liver Injury in Asia and Current Role of RUCAM for Causality Assessment in 11,160 Published Cases

Effectiveness and safety of Korean medicine for pain management after musculoskeletal surgery: a retrospective study

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