RT Journal Article
T1 Prior drug allergies are associated with worse outcome in patients with idiosyncratic drug-induced liver injury: A machine learning approach for risk stratification
A1 Niu, Hao
A1 Solis-Muñoz, Pablo
A1 García-Cortés, Miren
A1 Sanabria-Cabrera, Judith Adriana
A1 Robles-Díaz, María Mercedes
A1 Romero-Flores, Rocío
A1 Bonilla-Toyos, Elvira
A1 Ortega-Alonso, Aida
A1 Pinazo-Bandera, José M.
A1 Cabello-Porras, María Rosario
A1 Bessone, Fernando
A1 Hernandez, Nelia
A1 Lucena-González, María Isabel
A1 Andrade-Bellido, Raúl Jesús
A1 Medina-Cáliz, Inmaculada
A1 Álvarez-Álvarez, Ismael
K1 Hígado
K1 Alergias a los medicamentos
K1 Pronóstico médico
K1 Aprendizaje automático (Inteligencia artificial)
AB The impact of prior drug allergies (PDA) on the clinical features and outcomes of patients who develop idiosyncratic drug-induced liver injury (DILI) is largely unknown. We aimed to assess the clinical presentation and outcomes of DILI patients based on the presence or absence of PDA and explore the association between culprit drugs responsible for DILI and allergy. We analysed a well-vetted cohort of DILI cases enrolled from the Spanish DILI Registry. Bootstrap-enhanced least absolute shrinkage operator procedure was used in variable selection, and a multivariable logistic model was fitted to predict poor outcomes in DILI. Of 912 cases with a first episode of DILI, 61 (6.7%) had documented PDA. Patients with PDA were older (p = 0.009), had higher aspartate aminotransferase (AST) levels (p = 0.047), lower platelet count (p = 0.011) and higher liver-related mortality than those without a history of drug allergies (11% vs. 1.6%, p < 0.001). Penicillin was the most common drug associated with PDA in DILI patients (32%). A model including PDA, nR-based type of liver injury, female sex, AST, total bilirubin, and platelet count showed an excellent performance in predicting poor outcome in patients from the Spanish DILI Registry (area under the ROC curve [AUC] 0.887; 95% confidence interval [CI] 0.794 – 0.981) and the LATINDILI Network (AUC 0.932; 95% CI 0.884 – 0.981). Patients with suspected DILI should be screened for PDA as they would require a close monitoring for early detection of worsening clinical course.
PB Elsevier
YR 2023
FD 2023-12-08
LK https://hdl.handle.net/10630/28890
UL https://hdl.handle.net/10630/28890
LA eng
NO Hao Niu, Pablo Solis-Muñoz, Miren García-Cortés, Judith Sanabria-Cabrera, Mercedes Robles-Diaz, Rocío Romero-Flores, Elvira Bonilla-Toyos, Aida Ortega-Alonso, José M. Pinazo-Bandera, María R. Cabello, Fernando Bessone, Nelia Hernandez, M. Isabel Lucena, Raúl J. Andrade, Inmaculada Medina-Caliz, Ismael Alvarez-Alvarez, Prior drug allergies are associated with worse outcome in patients with idiosyncratic drug-induced liver injury: A machine learning approach for risk stratification, Pharmacological Research, Volume 199, 2024, 107030, ISSN 1043-6618, https://doi.org/10.1016/j.phrs.2023.107030. (https://www.sciencedirect.com/science/article/pii/S1043661823003869)
NO Funding for open access charge: Universidad de Málaga/CBUA. This work was supported by grants of Instituto de Salud Carlos III (ISCIII), cofounded by Fondo Europeo de Desarrollo Regional – FEDER, cofounded by European Union (grant number PI21/01248), and by the Agencia Española de Medicamentos y Productos Sanitarios. CIBERehd is funded by ISCIII. HN holds a postdoctoral research contract funded by Junta de Andalucía (POSTDOC_21_00780). JSC holds a Juan Rodés contract (JR21/00066), JMP-B holds a Rio Hortega contract (CM21/00074), and IAA holds a Sara Borrell contract (CD20/00083), funded by ISCIII. This project has received funding from the European Horizon´s research and innovation program HORIZON-HLTH-2022-STAYHLTH-02 under agreement No 101095679. Open Access funding provided thanks to the CRUE-CSIC agreement with Elsevier.
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 21 ene 2026