Abstract

DRUG INDUCED HEPATOTOXICITY- A SYSTEMATIC META- REVIEW

Harman Dhillon, Abhitinder Kumar and Nitish Bhatia*

ABSTRACT

Backgorund: Hepatotoxicity or hepatic damage is a common adverse effect of many of the drugs which are under regular medical usage. The clinically beneficial effect of drugs often gets overshadowed by profound hepatotoxicity exhibited by their regular usage and thus becomes an important cause of poor patient compliance. Many clinically effective medications fall into disrepute due to their hepatotoxic profile. Moreover, idiosyncractic hepatotoxic reactions are also common in clinical practice. Methods: A PubMed/Medline search was performed using the MeSH terms “liver disease” (drug effects, injuries, pathology) and “drug-induced liver injury”. The search was filtered by articles with keywords in the title or summary published until December 2019 in English and for which access was available to the full text. Articles were classified as case reports, reviews, systematic reviews, clinical trials, clinical trials controlled trials, randomized clinical trials, meta-analyzes and letters to the editor. Articles with evidence of hepatotoxicity only due to medications and those considered relevant to the subject were included. Results: The search identified 610 articles of which 402 met the inclusion criteria and were selected while 208 did not meet the inclusion criteria and were excluded. Forty-six other articles considered relevant for the review were included (Figure 1). A list of 181 drugs and 17 combined pharmaceutical forms or therapeutic regimens likely to cause hepatotoxicity was prepared. Conclusions: This review will find its utility as a reference source for devising and designing drug therapy by the healthcare professionals keeping in mind the hepatic status of the patient.

Keywords: Hepatotoxicity, Drug Usage, Liver Damage, Drug Therapy.