Drug-induced Liver Injury in Latin America: 10-year Experience of the Latin American DILI (LATINDILI) Network.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Bessone Fernando, Hernandez Nelia, Medina-Caliz Inmaculada, García-Cortés Miren, Schinoni María I, Mendizabal Manuel, Chiodi Daniela, Nunes Vinicius, Ridruejo Ezequiel, Pazos Ximena, Santos Genario, Fassio Eduardo, Parana Raymundo, Reggiardo Virginia, Tanno Hugo, Sanchez Adriana, Tanno Federico, Montes Pedro, Tagle Martin, Arrese Marco, Brahm Javier, Girala Marcos, Lizarzabal M Isabel, Carrera Enrique, Zerega Alina, Bianchi Carla, Reyes Laura, Arnedillo Daina, Cordone Antonella, Gualano Gisela, Jaureguizahar Fernanda, Rifrani Gabriel, Robles-Díaz Mercedes, Ortega-Alonso Aida, Pinazo-Bandera José M, Stephens Camilla, Sanabria-Cabrera Judith, Bonilla-Toyos Elvira, Niu Hao, Alvarez-Alvarez Ismael, Lucena M Isabel, Andrade Raul J
Аннотация
METHODS: Demographics, clinical presentation, histological findings and outcome of prospectively recruited DILI cases in the LATINDILI Network were analyzed. Suspected culprit drugs were classified according to the Anatomical Therapeutic Chemical classification. Causality was assessed using the Roussel Uclaf Causality Assessment Method (RUCAM) scale.
RESULTS: Overall, 468 idiosyncratic DILI cases were analyzed (62% women; mean age, 49 years). Hepatocellular injury predominated (62%); jaundice was present in 60% of patients, and 42% were hospitalized. Of the cases, 4.1% had a fatal outcome, and 24 patients (12%) developed chronic DILI. The most common drug classes were systemic anti-infectives (31%), musculoskeletal agents (12%), antineoplastic and immunomodulating agents (11%), and herbal and dietary supplements (9%). Notably, none of the patients with DILI due to antibacterials or immunosuppressants had a fatal outcome. In fact, Hy's law showed to have drug-specific predictive value, with anti-tuberculosis drugs, nimesulide, and herbal and dietary supplements associated with the worst outcome, whereas DILI caused by amoxicillin-clavulanate, nitrofurantoin, and diclofenac, which fulfilled Hy's law, did not have a fatal outcome.
CONCLUSION: Features of DILI in Latin America are comparable to other prospective registries. However, the pattern of drugs responsible for DILI differs. An increasing incidence of herbal and dietary supplements, with high mortality rate, and likewise, nimesulide and nitrofurantoin, was noted. Thus, public health policies should raise awareness of the potential adverse effects of these compounds.