Application of glucocorticosteroid in drug induced liver injury

Abstract

Abstract: Objective To investigate the indication and timing of glucocorticosteroid (GC) therapy for drug induced liver injury(DILI). Methods This study retrospectively analyzed the demographic characteristics, etiology and clinical manifestations of 33 patients with DILI in our hospital from 2018 to 2020. Patients were divided into 2 groups, 21 patients in control group received routine medical treatment, 12 patients in treatment group were given GC combined with routine medical treatment. The results of laboratory test including liver function were analyzed. Furthermore, the effective rate and side effects were also observed during the treatment. Results GC significantly improved the effective rate of therapy for DILI, especially severe liver injury. There was no rebound of liver function while tapering GC or GC related side effects during the treatment. Conclusion It is safe and efficient to use GC in early stage of DILI.

Key words: lucocorticosteroid, Acute, Severe liver injury, Drug-induced liver injury, Treatment

LI Wen-ting, YANG Liang, HE Hong-liang, ZHAO Zong-hao, LI Yi. Application of glucocorticosteroid in drug induced liver injury[J]. Chinese Hepatolgy, 2020, 25(7): 676-678.

References

[1] 中华医学会肝病学分会药物性肝病学组. 药物性肝损伤诊治指南. 肝脏, 2015, 20: 750-767.
[2] 魏巍,曹武奎,李谦. 糖皮质激素在肝功能衰竭中治疗作用的研究进展. 肝脏, 2015,20: 257-259.
[3] 王炳元.重症酒精性肝炎需要关注的几个问题.实用肝脏病杂志, 2014, 17:3-4.
[4] Gravbrot N, Sundararajan S. Severe drug-induced liver injury from combination encorafenib/binimetinib. Case Rep Oncol Med,2019,2019:3051945.
[5] Giordano C, Rivas J, Zervos X. An update on treatment of drug-induced liver injury. J Clin Transl Hepatol,2014, 2:74-79.
[6] Shen T, Liu Y, Shang J, Incidence and etiology of drug-induced liver injury in mainland China. Gastroenterology,2019, 156:2230-2241.
[7] Xiao X, Tang J, Mao Y,et al. Guidance for the clinical evaluation of traditional Chinese medicine-induced liver injuryIssued by China Food and Drug Administration. Acta Pharm Sin B,2019, 9:648-658.
[8] 朱孝雷,吴静. 58 例药物性肝功能损害案例的不良反应分析及其对策. 抗感染药学,2019, 16:641-643.
[9] Khoury T, Rmeileh AA, Yosha L, et al. Drug induced liver injury: review with a focus on genetic factors, tissue diagnosis, and treatment options. J Clin Transl Hepatol,2015, 3:99-108.
[10] Chin M, Levy RD, Yoshida EM, et al. Sitaxsentan-induced acute severe hepatitis treated with glucocorticoid therapy. Can Respir J, 2012, 19: e1-e2.
[11] 周超, 罗生强, 宫嫚, 等. 糖皮质激素在常见肝病治疗中的应用. 胃肠病学和肝病学杂志, 2015, 24: 15-17.
[12] 张玉果, 赵素贤, 李文聪, 等. 糖皮质激素治疗重症药物性肝损伤的临床研究. 肝脏, 2017, 22: 214-218.
[13] 黄春洋,单晶,廖慧钰,等. 甲基强的松龙治疗药物性肝损伤患者临床及实验室特点分析.实用肝脏病杂志, 2019, 22: 208-211.
[14] 贾长河,袁媛,刘博伟,等. 小剂量糖皮质激素治疗胆汁瘀积型药物性肝炎.中国实用医刊, 2011, 38: 68-71.
[15] Weber S, Benesic A, Rotter I, et al. Early ALT response to corticosteroid treatment distinguishes idiosyncratic drug-induced liver injury from autoimmune hepatitis. Liver Int,2019, 39:1906-1917.