RT Journal Article
T1 Clinical characteristics and outcome of drug-induced liver injury in the older patients: from the young-old to the oldest-old
A1 Weersink, Rianne A.
A1 Álvarez-Álvarez, Ismael
A1 Medina-Cáliz, Inmaculada
A1 Sanabria-Cabrera, Judith Adriana
A1 Robles-Díaz, María Mercedes
A1 Ortega-Alonso, Aida
A1 García-Cortés, Miren
A1 Bonilla, Elvira
A1 Niu, Hao
A1 Soriano, German
A1 Jiménez-Pérez, Miguel
A1 Hallal, Hacibe
A1 Blanco, Sonia
A1 Kaplowitz, Neil
A1 Lucena-González, María Isabel
A1 Andrade-Bellido, Raúl Jesús
K1 Hígado - Enfermedades
AB Old patients with hepatotoxicity have been scarcely studied in idiosyncratic drug-induced liver injury (DILI) cohorts. We sought for the distinctive characteristics of DILI in older patients across age groups. A total of 882 DILI patients included in the Spanish DILI Registry (33% ≥65 years) were categorized according to age: “young” (<65y); “young-old” (65-74y); “middle-old” (75-84y); and “oldest-old” (≥85y). All elderly groups had increasingly higher comorbidity burden (p<0.001) and polypharmacy (p<0.001). There was a relationship between jaundice and hospitalization (p<0.001), and both were more prevalent in the elderly age groups, especially in the oldest-old (88% and 69%, respectively) and the DILI episode was more severe (p=0.029). The proportion of females decreased across age groups from the young to the middle-old, yet in the oldest-old there was a distinct female predominance. Pattern of liver injury shifted towards cholestatic with increasing age among top culprit drugs amoxicillin- clavulanate, atorvastatin, levofloxacin, ibuprofen, and ticlopidine. The best cut-off point for increased odds of cholestatic DILI was 65y. Older patients had increased non-liver related mortality (p=0.030) as shown by the predictive capacity of MELD (OR=1.116; p<0.001), and comorbidity burden (OR=4.188; p=0.001) in the 6-month mortality. Older patients with DILI exhibited an increasingly predominant cholestatic phenotype across a range of culprit drugs other that amoxicillin-clavulanate, with increased non-liver related mortality and require a different approach to predict outcome. The oldest DILI patients exhibited a particular phenotype with more severe DILI episodes and need to be considered when stratifying older DILI populations.
PB Wiley
YR 2020
FD 2020-11-11
LK https://hdl.handle.net/10630/23627
UL https://hdl.handle.net/10630/23627
LA eng
NO Weersink RA, Alvarez-Alvarez I, Medina-Cáliz I, Sanabria-Cabrera J, Robles-Díaz M, Ortega-Alonso A, García-Cortés M, Bonilla E, Niu H, Soriano G, Jimenez-Perez M, Hallal H, Blanco S, Kaplowitz N, Lucena MI, Andrade RJ. Clinical Characteristics and Outcome of Drug-Induced Liver Injury in the Older Patients: From the Young-Old to the Oldest-Old. Clin Pharmacol Ther. 2021 Apr;109(4):1147-1158. doi: 10.1002/cpt.2108.
NO The present study has been supported by grants of Instituto de Salud Carlos III cofounded by Fondo Europeo de Desarrollo Regional - FEDER (contract numbers: PI 18/01804; PT17/0017/0020) and Agencia Española del Medicamento. SCReN and CIBERehd are funded by ISCIII. JSC holds a Rio Hortega (CM17/00243) and MR a “Joan Rodes” (JR16/00015) research contract from the National Health System, ISCIII. RAW held a University of Málaga visiting scientist scholarship.
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 19 ene 2026