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Biomarkers of idiosyncratic drug-induced liver injury (DILI) - a systematic review

Atallah, Edmond; Freixo, Cristiana; Alvarez-Alvarez, Ismael; Cubero, F. J.; Gerbes, Alexander L.; Kullak-Ublick, Gerd A.; Aithal, Guruprasad P.

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Authors

Edmond Atallah

Cristiana Freixo

Ismael Alvarez-Alvarez

F. J. Cubero

Alexander L. Gerbes

Gerd A. Kullak-Ublick



Abstract

Introduction: Idiosyncratic drug-induced liver injury (DILI) is an unpredictable event, and there are no specific biomarkers that can distinguish DILI from alternative explanations or predict its clinical outcomes. Areas covered: This systematic review summarizes the available evidence for all biomarkers proposed to have a role in the diagnosis or prognosis of DILI. Following a comprehensive search, we included all types of studies in humans. We included DILI cases based on any threshold criteria but excluded intrinsic DILI, commonly caused by paracetamol overdose. We classified studies into diagnostic and prognostic categories and assessed their methodological quality. After reviewing the literature, 14 studies were eligible. Expert Opinion: Diagnostic studies were heterogeneous with regard to the study population and outcomes measured. Prognostic models were developed by integrating novel biomarkers, risk scores, and traditional biomarkers, which increased their prognostic ability to predict death or transplantation by 6 months. This systematic review highlights the case of need for non-genetic biomarkers that distinguish DILI from acute liver injury related to alternative etiology. Biomarkers with the potential to identify serious adverse outcomes from acute DILI should be validated in independent prospective cohorts with a substantial number of cases.

Citation

Atallah, E., Freixo, C., Alvarez-Alvarez, I., Cubero, F. J., Gerbes, A. L., Kullak-Ublick, G. A., & Aithal, G. P. (2021). Biomarkers of idiosyncratic drug-induced liver injury (DILI) - a systematic review. Expert Opinion on Drug Metabolism and Toxicology, 17(11), 1327-1343. https://doi.org/10.1080/17425255.2021.1999410

Journal Article Type Article
Acceptance Date Oct 21, 2021
Online Publication Date Nov 15, 2021
Publication Date Nov 15, 2021
Deposit Date Nov 25, 2021
Publicly Available Date Mar 29, 2024
Journal Expert Opinion on Drug Metabolism and Toxicology
Print ISSN 1742-5255
Electronic ISSN 1744-7607
Publisher Informa UK Limited
Peer Reviewed Peer Reviewed
Volume 17
Issue 11
Pages 1327-1343
DOI https://doi.org/10.1080/17425255.2021.1999410
Keywords Pharmacology; Toxicology; General Medicine
Public URL https://nottingham-repository.worktribe.com/output/6788858
Publisher URL https://www.tandfonline.com/doi/full/10.1080/17425255.2021.1999410

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