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Karkhanis, Jamuna; Verna, Elizabeth C.; Chang, Matthew S.; Stravitz, R. Todd; Schilsky, Michael L.; Lee, William M.; Brown, Robert S.

doi:10.1002/hep.27110

Cited by 2 publications

(3 citation statements)

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“…A retrospective analysis of 361 patients with autoimmune ALF, indeterminate ALF and drug-induced ALF suggested that corticosteroids treatment did not improve the overall survival. In the subgroup of patients with drug-induced ALF, the rate of survival was 69% for those who received corticosteroids versus 66% for those who did not (p=0.82) [23]. On the other hand, Czaja et al reported that corticosteroid therapy was effective in female patients with drug induced autoimmune hepatitis [24].…”

Section: Discussionmentioning

confidence: 98%

“…Currently, there is no de nitive therapy or approved antidote available for idiosyncratic DILI. Empiric uses of corticosteroid are sometimes given when all other treatments fail, although it is not generally recommended due to the lack of obvious clinical bene t in previously reported studies [22][23][24]. A retrospective analysis of 361 patients with autoimmune ALF, indeterminate ALF and drug-induced ALF suggested that corticosteroids treatment did not improve the overall survival.…”

Section: Discussionmentioning

confidence: 99%

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Prednisolone Therapy Accelerated Recovery of Severe Drug-Induced Liver Injury: A Prospective Randomized Controlled Study

Zhu

Song

Liu

et al. 2021

Preprint

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Background Drug-induced liver injury (DILI) is one of the most serious adverse drug reactions and the incidence has been increasing rapidly. Accumulating evidence suggested that the immune activation and systemic inflammatory responses play a significant role in the progression of DILI. Corticosteroids are often used in DILI, but clinical usefulness remain controversial. We therefore conducted a prospective randomized controlled study to investigate whether corticosteroid therapy can accelerate recovery and reduce mortality in severe DILI (SDILI).Methods SDILI patients with total bilirubin (TBIL) ≥171 μmol/L presented to Fifth Medical Center of PLA General Hospital, Beijing from 1/1/2015 to 31/12/2019 were randomized into prednisolone group and control group. The primary endpoints were proportion of subjects with resolution of SDILI defined as decrease in TBIL by at least 35 μmol/L to below 171 μmol/L and overall survival at 6 months. Patients in prednisolone group received prednisolone 60 mg/day therapy for the first 7 days. Patients reaching the primary endpoint or achieved decrease in TBIL by more than 35 umol/L on day 8 would continue on tapering doses of prednisolone, otherwise prednisolone would be discontinued.Results On day 8, 50.7% (34/67) and 26.5% (18/68) of the subjects in the prednisolone group and control group achieved the primary endpoint respectively, p=0.002. However, there was no significant difference in overall survival at 6 months, 95.52% (64/67) vs 91.2% (62/68), p= 0.2. All deaths in both groups occurred in patients who failed to achieve SDILI resolution on day 8.Conclusions Prednisolone therapy may accelerate recovery of SDILI and shorten hospitalization.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Prednisolone Therapy Accelerated Recovery of Severe Drug-Induced Liver Injury: A Prospective Randomized Controlled Study

Zhu

Song

Liu

et al. 2021

Preprint

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“…Однако в 15-20 % случаев причину острой печёночной недостаточности установить не удаётся. Это могут быть не установленные инфекционные, ядовитые, аутоиммунные и метаболические дисфункции [28,36].…”

Section: об этиологии и патогенезе печёночной недостаточностиunclassified

Current Approach to Diagnosis and Treatment for Liver Failure (Literature Review)

Плеханов¹,

Plekhanov²,

Товаршинов³

et al. 2016

Бюллетень Восточно-Сибирского Научного Центра Сибирского Отделения Российской Академии Медицинских Наук

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Currently, the world is marked rise in the number of patients with liver disease. Approximately 100,000 patients hepatitis complicated by acute liver failure, with mortality in this disease reaches 70-90% despite the use of modern methods of treatment Currently, there are more than 20 concepts of this disease. In 15-20% of cases the cause of acute liver failure can not be established. Most clinicians believe that the pathogenesis of liver failure is a strong humoral and hyperimmune response, resulting in massive necrosis of liver cells. Diagnosis of liver failure based on anamnesis, clinical, biochemical and electroencephalographic changes. Traditional conservative therapy of acute liver failure in the first place based on the measures taken to address the etiological factor. Transplantation is an effective measure in acute liver failure. In the world there are a sufficient number of prognostic scales, criteria and risk factors of acute liver failure. Each of them has its own characteristics, but a unified system of prognostic estimation of arrester.

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Cited by 2 publications

References 2 publications

Prednisolone Therapy Accelerated Recovery of Severe Drug-Induced Liver Injury: A Prospective Randomized Controlled Study

Prednisolone Therapy Accelerated Recovery of Severe Drug-Induced Liver Injury: A Prospective Randomized Controlled Study

Current Approach to Diagnosis and Treatment for Liver Failure (Literature Review)

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