Anticancer drugs are the first cause of drug-induced liver injury in a reference hospital

Liver Int. 2024 Feb;44(2):286-292. doi: 10.1111/liv.15821. Epub 2023 Dec 22.

Abstract

Drug-induced liver injury (DILI) is a challenging liver disorder for hepatologists. We aimed to assess the pattern and causes of DILI in a tertiary hospital. We registered prospectively all patients referred with suspicion of DILI from 2018 to 2023. A total of 106 patients fulfilled the diagnostic criteria (30 caused by paracetamol were excluded; total number 76). The pattern of liver injury was hepatocellular in 55 (72%). Drugs causing DILI were antineoplastic (26%), antibiotics (24%), analgesics (12%), and recreational drugs (9%). Regarding clinical outcomes, 39 (51%) required hospitalization and 7 (9%) underwent a liver transplantation or died from acute liver injury. We identified 126 additional patients with DILI due to immune check-point inhibitors who were not referred to a liver disease specialist. Antineoplastic drugs have become the first cause of DILI in hospitals. A multidisciplinary approach and specific educational tools to increase DILI awareness are needed among different specialists.

Keywords: antineoplastic drugs; diagnosis; oncologists.

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Chemical and Drug Induced Liver Injury* / etiology
  • Humans
  • Liver Diseases*
  • Tertiary Care Centers

Substances

  • Antineoplastic Agents