Trends in drug-induced liver injury (DILI): a case report-based analysis of clinical presentation, severity, preventability, seriousness, and outcomes over the last decade.

BACKGROUND

DILI causes about 50 % of acute liver failures globally, affecting 14-19 per 100,000 annually, and is a leading cause of liver failure and drug withdrawals in the USA and Europe.

METHODS

This study reviewed 60 case reports of drug-induced liver injury from Medline/PubMed (2015-2025) at Kalpana Chawla Government Medical College. Initially, 108 reports were identified using specific criteria, screened independently by two teams, with duplicates and ineligible reports removed for analysis.

RESULTS

This analysis of 60 drug-induced liver injury case reports from PubMed/Medline in past decade found that patients averaged 54.6 years old, with 55 % female. Most cases occurred in the USA, China, and Japan. Jaundice (42 %) and fatigue (34 %) were common symptoms. Hepatocellular injury was most prevalent (45 %). Atorvastatin and Methimazole were frequently implicated drugs, with 75 % involving polypharmacy. Most ADRs occurred within 2.3 months of treatment initiation. Drug withdrawal was the primary intervention (93 %), resulting in full recovery in 87 % of cases, though 3 % were fatal.

CONCLUSIONS

Analysis of 60 DILI cases identified risk factors such as age over 55, female sex, high doses, and polypharmacy. Most cases were drug-related; 78 % required hospitalization. Prevention could reduce cases by up to 50 %, with full recovery upon drug withdrawal.