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Causality assessment in drug-induced liver injury.

Abstract

Assigning causality in drug-induced liver injury (DILI) due to a particular medication or herbal and dietary supplement relies on clinical history, exclusion of competing causes, prior reports of DILI, and judgment-no objective laboratory or histological tests exist to confirm a diagnosis of suspected DILI. Current causality assessment instruments are based on algorithmic scoring systems but are not widely used. Expert opinion remains the gold standard, but is cumbersome and has limited reproducibility. The lack of a valid and widely available causality assessment method hinders the identification of genetic and biochemical markers that may help better define DILI. Emerging technologies in pharmacogenomics and toxicogenomics may identify such markers if well-defined DILI cases and controls can provide tissue samples for analysis. In this article, current causality assessment instruments, including expert opinion, are discussed, and the necessary features for an improved instrument are provided.

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  • Publisher Full Text
  • Authors+Show Affiliations

    UNC Liver Program, Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina 27599-7584, USA. paul_hayashi@med.unc.edu

    Source

    Seminars in liver disease 29:4 2009 Nov pg 348-56

    MeSH

    Adverse Drug Reaction Reporting Systems
    Algorithms
    Biomarkers
    Chemical and Drug Induced Liver Injury
    Dietary Supplements
    Drug-Related Side Effects and Adverse Reactions
    Expert Testimony
    Genetic Testing
    Humans
    Models, Statistical
    Plant Preparations
    Risk Assessment
    Risk Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    19826968

    Citation

    Hayashi, Paul H.. "Causality Assessment in Drug-induced Liver Injury." Seminars in Liver Disease, vol. 29, no. 4, 2009, pp. 348-56.
    Hayashi PH. Causality assessment in drug-induced liver injury. Semin Liver Dis. 2009;29(4):348-56.
    Hayashi, P. H. (2009). Causality assessment in drug-induced liver injury. Seminars in Liver Disease, 29(4), pp. 348-56. doi:10.1055/s-0029-1240003.
    Hayashi PH. Causality Assessment in Drug-induced Liver Injury. Semin Liver Dis. 2009;29(4):348-56. PubMed PMID: 19826968.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Causality assessment in drug-induced liver injury. A1 - Hayashi,Paul H, Y1 - 2009/10/13/ PY - 2009/10/15/entrez PY - 2009/10/15/pubmed PY - 2009/12/18/medline SP - 348 EP - 56 JF - Seminars in liver disease JO - Semin. Liver Dis. VL - 29 IS - 4 N2 - Assigning causality in drug-induced liver injury (DILI) due to a particular medication or herbal and dietary supplement relies on clinical history, exclusion of competing causes, prior reports of DILI, and judgment-no objective laboratory or histological tests exist to confirm a diagnosis of suspected DILI. Current causality assessment instruments are based on algorithmic scoring systems but are not widely used. Expert opinion remains the gold standard, but is cumbersome and has limited reproducibility. The lack of a valid and widely available causality assessment method hinders the identification of genetic and biochemical markers that may help better define DILI. Emerging technologies in pharmacogenomics and toxicogenomics may identify such markers if well-defined DILI cases and controls can provide tissue samples for analysis. In this article, current causality assessment instruments, including expert opinion, are discussed, and the necessary features for an improved instrument are provided. SN - 1098-8971 UR - https://www.unboundmedicine.com/medline/citation/19826968/Causality_assessment_in_drug_induced_liver_injury_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1240003 DB - PRIME DP - Unbound Medicine ER -