Use of Hy's Law and a New Composite Algorithm to Predict Acute Liver Failure in Patients With Drug-Induced Liver Injury

Robles‐Díaz, Mercedes; Lucena, M. Isabel; Kaplowitz, Neil; Stephens, Camilla; Medina‐Cáliz, Inmaculada; González-Jiménez, A.; Ulzurrun, Eugenia; González, Ana Fernández; Fernández, M. Carmen; Romero–Gómez, Manuel; Jiménez‐Pérez, Miguel; Bruguera, Miguel; Prieto, M.; Bessone, Fernando; Hernández, Nelia; Arrese, Marco; Andrade, Raúl J.

doi:10.1053/j.gastro.2014.03.050

Cited by 285 publications

(282 citation statements)

References 29 publications

Supporting

Mentioning

265

Contrasting

Unclassified

Order By: Relevance

“…7 Amoxicillin-clavulanate is the most common individual drug implicated in DILI as confirmed by both European and American studies (Table 1 ). [6][7][8][9][10] In some Asian countries, however, HDS are implicated in more than 70% of all DILI. 11 DILI includes the whole spectrum from asymptomatic elevation in liver tests to acute liver failure (ALF).…”

Section: Epidemiologymentioning

confidence: 99%

“…12 In idiosyncratic DILI, approximately 4% progress to ALF; risk factors are female gender (70%) and hepatocellular DILI (80%). 8 The drugs most commonly implicated in ALF include antituberculosis therapies (ATT), HDS, sulpha-containing drugs, nitrofurantoin, phenytoin, sodium valproate, flutamide and amoxicillin-clavulanate. 8,14 Types of DILI Idiosyncratic DILI can be classified according to the pattern of liver tests observed -hepatocellular, cholestatic, or mixed.…”

Section: Epidemiologymentioning

confidence: 99%

“…8 The drugs most commonly implicated in ALF include antituberculosis therapies (ATT), HDS, sulpha-containing drugs, nitrofurantoin, phenytoin, sodium valproate, flutamide and amoxicillin-clavulanate. 8,14 Types of DILI Idiosyncratic DILI can be classified according to the pattern of liver tests observed -hepatocellular, cholestatic, or mixed. This classification was first established by the Council for International Organizations of Medical Sciences (CIOMS) 15 and has recently been modified by the US Food and Drug s105 Administration (FDA) Drug Hepatotoxicity Steering Committee.…”

Section: Epidemiologymentioning

confidence: 99%

See 2 more Smart Citations

Drug-induced liver injury

2016

View full text Add to dashboard Cite

Drug-induced liver injury (DILI) remains the most common cause of acute liver failure (ALF) in the western world. Excluding paracetamol overdose, nearly all DILI encountered in the clinical setting is idiosyncratic in nature because affected individuals represent only a small proportion of those treated with such drugs. In many cases, the mechanism for idiosyncrasy is immune-mediation and is often identifi ed by genetic risk determined by human leukocyte antigen variants. In the absence of diagnostic tests and/or biomarkers, the diagnosis of DILI requires a high index of suspicion after diligently excluding other causes of abnormal liver tests. Antibiotics are the class of drugs most frequently associated with idiosyncratic DILI, although recent studies indicate that herbal and dietary supplements are an increasingly recognised cause. It is imperative that upon development of DILI the culprit drug be discontinued, especially in the presence of elevated transaminases (aspartate aminotransferase/alanine aminotransferase ratio ≥5 times the upper limit of normal) and/or jaundice. Risk factors for the development ALF include hepatocellular DILI and female gender, the treatment being supportive with some benefi t of N-acetylcysteine in the early stages. In view of the poor transplant-free survival in idiosyncratic DILI, early consideration for liver transplant is mandatory. KEYWORDS : Autoimmune hepatitis , cholestasis , drug-induced acute liver failure , herbal and dietary supplements , hepatocellular DILI , hepatotoxicity IntroductionAt a regulatory level, drug-induced liver injury (DILI) is the commonest reason for withdrawing drugs from the market and/or issuing warnings and modification of use.1 DILI is classified as either predictable or unpredictable (idiosyncratic). 2The former tends to be dose-related, has a short latency (days), is due to direct toxicity of the drug or its metabolite, and is ABSTRACT Drug-induced liver injuryreproducible in animal models (eg paracetamol overdose). 3The vast majority of DILI, however, is idiosyncratic or unpredictable -it is unexpected based on the pharmacological actions of the drug and in most cases routine animal toxicology fails to identify the risk of subsequent clinical toxicity. 4 This review shall largely focus on idiosyncratic DILI .

show abstract

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

See 1 more Smart Citation

Drug-induced liver injury

2016

View full text Add to dashboard Cite

show abstract

“…Interestingly, the phenotypes of liver damage as characterized by liver biochemistry (hepatocellular, cholestatic and mixed) overlap among registries as does the severity. [9][10][11] New clinical findings provided by statistical analysis of the large DILI cohorts from the consortia include the recognition of female sex, hepatocellular type of damage and high bilirubin levels as risk factors for fulminant liver failure and death, [9,15] the influence of age and sex on the phenotypic expression of hepatotoxicity [16] and the higher mortality risk in patients with preexisting liver disease. [11] DILI Registries have also provided consistent figures on the therapeutic group of drugs most commonly implicated (Table 2) [9][10][11] and the growing problem with herbals and dietary supplements in the US.…”

Section: Clinical Dili Consortiamentioning

confidence: 99%

“Drug-Induced Liver Injury Clinical Consortia: a global research response for a worldwide health challenge”

Andrade

Ortega‐Alonso

Lucena

2016

Expert Opinion on Drug Metabolism & Toxicology

Self Cite

View full text Add to dashboard Cite

“…Roblez-Diaz et al (4) improved the definition of Hy's Law and developed a better model. They underlined the value of AST level and AST/ALT ratio to predict a fatal outcome at any time point.…”

mentioning

confidence: 99%

How will I know whether “an apple is ripe or rotten”? A new proposed composite algorithm to predict acute liver failure in patients with drug-induced liver injury

Tahan

2014

Turk J Gastroenterol

View full text Add to dashboard Cite

Use of Hy's Law and a New Composite Algorithm to Predict Acute Liver Failure in Patients With Drug-Induced Liver Injury

Cited by 285 publications

References 29 publications

Drug-induced liver injury

Drug-induced liver injury

“Drug-Induced Liver Injury Clinical Consortia: a global research response for a worldwide health challenge”

How will I know whether “an apple is ripe or rotten”? A new proposed composite algorithm to predict acute liver failure in patients with drug-induced liver injury

Contact Info

Product

Resources

About