Drug-induced liver injury (DILI) poses a significant challenge even for expert clinicians. There is dearth of data about the epidemiology, as the real incidence and prevalence of the disorder are underestimated, and in few cases, the pharmacovigilance chain failed as cases are largely underreported. The authors of the current study reviewed available literature data and discuss their clinical experience about a prospective cohort of 185 patients who were diagnosed with DILI.

Several papers were recognized by literature search, which were chosen according to the content including the epidemiology of DILI. After the evaluation of our prospective cohort, consecutively collected since January 2000 to December 2016, the authors determined the frequency of different drug classes involved in DILI and their related clinical outcomes.

The outcome revealed that in our cohort of 185 patients, 56% were females and 44% males; the mean age was 53 years. Among these, if about 70% of patients were 40 years old; only 2% had a history of chronic liver disease. A total of 57.8% patients clinically displayed a hepatocellular pattern, whereas 18.3% a cholestatic and 23.2% a mixed one. Almost 23.4% patients were administered with antibiotics, NSAIDs for 35.5%, immunosuppressants for 10.9%, statins for 4.3%, anti-platelets and anti-psychiatric drugs for 7.6%, and other drugs for 9%. Additionally, antibiotics, NSAIDs, and immunosuppressant were more commonly implicated in chronicity, whereas statins, anti-psychiatric and anti-platelets drugs were not. 

Thus, the authors in the current review discussed their detailed clinical experience in the field of DILI. They evaluated that lot of efforts were needed to emphasize a physician to the likelihood of occurrence of DILI in a patient with the acute liver disease.

Source: Licata A, Minissale MG, Calvaruso V, Craxì A. A focus on epidemiology of drug-induced liver injury: analysis of a prospective cohort. Eur Rev Med Pharmacol Sci. 2017 Mar;21(1 Suppl):112-121. PMID: 28379588.