RT Journal Article
T1 Potential benefit and lack of serious risk from corticosteroids in drug-induced liver injury: an international, multicentre, propensity score-matched analysis
A1 Niu, Hao
A1 Ma, Jiayi
A1 Medina-Cáliz, Inmaculada
A1 Robles-Díaz, María Mercedes
A1 Bonilla-Toyos, Elvira
A1 Ghabril, Marwan
A1 Lucena-González, María Isabel
A1 Álvarez-Álvarez, Ismael
A1 Andrade-Bellido, Raúl Jesús
K1 Riñones -- Efectos de los medicamentos
K1 Riñones -- Enfermedades -- Tratamiento
K1 Hormonas adrenocorticales -- Uso terapéutico
K1 Medicamentos -- Toxicología
K1 Farmacología
AB Background:The use of corticosteroids to treat patients with idiosyncratic drug-induced liver injury (DILI) relies on empirical clinical decisions.Aim:To investigate the relationship between corticosteroids and risk of acute liver failure (ALF) in patients with DILI and to assess if corticosteroid therapy was associated with improved outcomes in DILI patients.Methods:We analysed bona fide idiosyncratic DILI cases from the Spanish DILI Registry and Indiana University School of Medicine. Patients treated with corticosteroids were compared to those who did not receive any treatment. Nearest neighbour propensity score matching analyses were conducted.Results:We enrolled 724 patients, 106 under corticosteroid therapy, in whom there was over-representation of more severe injury and autoimmune features, and 618 who did not receive any treatment. In an analysis of 80 pairs of propensity score-matched patients, corticosteroid administration was not associated with an increased risk of developing ALF (odds ratio = 0.65; 95% confidence interval [CI]: 0.18–2.40; p = 0.518). Furthermore, in an additional analysis, a Cox regression model that included 41 propensity score-matched pairs showed that patients receiving corticosteroids had a significantly higher normalisation rate of liver enzymes than untreated patients (hazard ratio [HR] = 1.84; 95% CI: 1.02–3.32; p = 0.043), particularly in patients with serious injury who did not resolve within 30 days (HR = 2.79; 95% CI: 1.20–6.50; p = 0.018).Conclusion:Corticosteroid therapy did not worsen outcome in DILI patients. Indeed, corticosteroid administration was associated with a greater rate of normalisation of liver enzymes in patients with serious DILI.
PB Wiley
YR 2022
FD 2022-12-22
LK https://hdl.handle.net/10630/26504
UL https://hdl.handle.net/10630/26504
LA eng
NO Niu, H, Ma, J, Medina-Caliz, I, Robles-Diaz, M, Bonilla-Toyos, E, Ghabril, M, et al. Potential benefit and lack of serious risk from corticosteroids in drug-induced liver injury: An international, multicentre, propensity score-matched analysis. Aliment Pharmacol Ther. 2023; 57: 886– 896. https://doi.org/10.1111/apt.17373
NO Funding for open access charge: Universidad de Málaga / CBUA.This study was funded by Instituto de Salud Carlos III (ISCIII) cofounded by Fondo Europeo de Desarrollo Regional - FEDER (contract numbers: PI18/00901, PI19/00883, PI21/01248 and PT20/000127), Consejería de Salud de Junta de Andalucía (contract number: PI-0310-2018), and Agencia Española de Medicamentos y Productos Sanitarios. CIBERehd and PlataformaISCIII Ensayos Clínicos are funded by ISCIII. HN holds a postdoctoral research contract funded by Junta de Andalucia (POSTDOC_21_00780). I.A.-A. holds a Sara Borrell contract funded by ISCIII (CD20/00083). This article/publication is based upon work from COST Action CA17112, supported by COST (European Cooperation in Science and Technology). www.cost.eu.
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 26 feb 2026