DILI Associated with Skin Reactions

Rahnama‐Moghadam, Sahand; Tillmann, Hans L.

doi:10.1007/s11901-018-0414-x

Cited by 4 publications

(3 citation statements)

References 51 publications

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“…Although there are significant differences in which drugs are most likely to cause SCARs versus DILI [15], a number of different causative drugs have been identified as responsible for SCARs associated with DILI (Table 1). The most frequent culprit drugs might vary to some extent across countries, which may reflect differences in prescription habits and host susceptibility.…”

Section: Introductionmentioning

confidence: 99%

Critical Review of Gaps in the Diagnosis and Management of Drug-Induced Liver Injury Associated with Severe Cutaneous Adverse Reactions

Paz

Niu

Segovia-Zafra

et al. 2021

JCM

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Drug-induced liver injury (DILI) encompasses the unexpected damage that drugs can cause to the liver. DILI may develop in the context of an immunoallergic syndrome with cutaneous manifestations, which are sometimes severe (SCARs). Nevirapine, allopurinol, anti-epileptics, sulfonamides, and antibiotics are the most frequent culprit drugs for DILI associated with SCARs. Interestingly, alleles HLA-B*58:01 and HLA-A*31:01 are associated with both adverse reactions. However, there is no consensus about the criteria used for the characterization of liver injury in this context, and the different thresholds for DILI definition make it difficult to gain insight into this complex disorder. Moreover, current limitations when evaluating causality in patients with DILI associated with SCARs are related to the plethora of causality assessment methods and the lack of consensual complementary tools. Finally, the management of this condition encompasses the treatment of liver and skin injury. Although the use of immunomodulant agents is accepted for SCARs, their role in treating liver injury remains controversial. Further randomized clinical trials are needed to test their efficacy and safety to address this complex entity. Therefore, this review aims to identify the current gaps in the definition, diagnosis, prognosis, and management of DILI associated with SCARs, proposing different strategies to fill in these gaps.

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Section: Introductionmentioning

confidence: 99%

Critical Review of Gaps in the Diagnosis and Management of Drug-Induced Liver Injury Associated with Severe Cutaneous Adverse Reactions

Paz

Niu

Segovia-Zafra

et al. 2021

JCM

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“…This differs from iDILI, which is not necessarily dose-dependent. In the past it was believed that iDILI was thought to be largely independent of drug dose, but evidence suggests that the risk for iDILI may increase with the total daily dose [1,2]. However, other factors such as fasting, alcohol consumption, genetic polymorphisms and race/ethnicity modify susceptibility and outcomes [3,4,5].…”

Section: Introductionmentioning

confidence: 99%

“…However, that approach does not take into consideration the frequency with which the drug was prescribed. Thus, an alternative approach would be to use drugs' physiochemical properties such as daily dose, lipophilicity and hepatic metabolism, [2,50] which may better reflect the risk for DILI associated with a given drug.…”

mentioning

confidence: 99%

Tools for causality assessment in drug-induced liver disease

Tillmann

Suzuki

Barnhart

et al. 2019

Current Opinion in Gastroenterology

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Purpose of Review-There are three liver-specific causality assessment tools currently available to guide clinical diagnosis of Drug Induced Liver Injury (DILI): Roussel-Uclaf-Causality-Assessment-Method (RUCAM), Digestive-Disease-Week Japan 2004 scale (DDW-J), and Clinical Diagnostic Scale (CDS). The purpose of this review is to assess these tools and discuss how to improve the causality assessment process as a whole. Recent findings: Existing DILI-specific causality assessment tools are surprisingly similar and exhibit only minor differences. We reviewed the literature on currently used causality assessment tools, identified areas for future improvement, and herein propose approaches for refinement. Opportunities to improve current models, as well as the assessment process in general include in particular provision of more precise clinical detail and to perhaps add new components to scoring systems. For example, the incorporation of drug-specific clinical signature patterns, accounting for a drug's inherent hepatotoxicity potential, and/or incorporation of other drug properties to scoring systems may allow enhancement. Further, more systemic exclusion of competing diagnoses is needed. Finally, causality assessment processes will likely benefit from a data-driven and computer-assisted approach.

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Hepatotoxicity; Drug-Induced Liver Injury

Tillmann¹

2020

Encyclopedia of Gastroenterology

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DILI Associated with Skin Reactions

Cited by 4 publications

References 51 publications

Critical Review of Gaps in the Diagnosis and Management of Drug-Induced Liver Injury Associated with Severe Cutaneous Adverse Reactions

Critical Review of Gaps in the Diagnosis and Management of Drug-Induced Liver Injury Associated with Severe Cutaneous Adverse Reactions

Tools for causality assessment in drug-induced liver disease

Hepatotoxicity; Drug-Induced Liver Injury

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