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dc.contributor.authorWeersink, Rianne A.
dc.contributor.authorAlvarez-Alvarez, Ismael
dc.contributor.authorMedina-Caliz, Inmaculada
dc.contributor.authorSanabria-Cabrera, Judith Adriana 
dc.contributor.authorRobles-Díaz, María Mercedes 
dc.contributor.authorOrtega-Alonso, Aida
dc.contributor.authorGarcía-Cortés, Miren
dc.contributor.authorBonilla, Elvira
dc.contributor.authorNiu, Hao
dc.contributor.authorSoriano, German
dc.contributor.authorJiménez-Pérez, Miguel 
dc.contributor.authorHallal, Hacibe
dc.contributor.authorBlanco, Sonia
dc.contributor.authorKaplowitz, Neil
dc.contributor.authorLucena-González, María Isabel 
dc.contributor.authorAndrade-Bellido, Raúl Jesús 
dc.date.accessioned2022-01-17T12:51:44Z
dc.date.available2022-01-17T12:51:44Z
dc.date.created2021-12-20
dc.date.issued2020-11-11
dc.identifier.citationWeersink 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.es_ES
dc.identifier.urihttps://hdl.handle.net/10630/23627
dc.description.abstractOld 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.es_ES
dc.description.sponsorshipThe 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.es_ES
dc.language.isoenges_ES
dc.publisherWileyes_ES
dc.rightsinfo:eu-repo/semantics/openAccesses_ES
dc.subjectHígado - Enfermedadeses_ES
dc.subject.otherdrug-induced liver injuryes_ES
dc.subject.otherelderlyes_ES
dc.subject.otheroldest-oldes_ES
dc.subject.otherCholestatices_ES
dc.subject.othercomorbitityes_ES
dc.subject.othermortalityes_ES
dc.titleClinical characteristics and outcome of drug-induced liver injury in the older patients: from the young-old to the oldest-oldes_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.centroFacultad de Medicinaes_ES
dc.identifier.doi10.1002/cpt.2108
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersiones_ES


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