P-11 POTENTIALLY HEPATOTOXIC DRUGS ARE STILL BEING PRESCRIBED TO LIVER DISEASE PATIENTS UNDER TERTIARY CARE: IT IS TIME TO SAY ENOUGH

Dorelo, Rodrigo; Barcelos, Samantha T.A.; Barros, Magela; Elustondo, Valeria; Pérez, Ysela Y.P.; Oricchio, Martin; Uribe, Nelson D.S.; Hernandez, Nelia; Joveleviths, Dvora; Álvares-da-Silva, Mário R.

doi:10.1016/j.aohep.2021.100377

ISSN: 1665-2681

Annals of Hepatology (AoH) is an international, open access journal published bi-monthly with funds from the Fundación Clínica Médica Sur. It is the official journal of the Mexican Association of Hepatology (AMH), the Latin American Association for the Study of the Liver (ALEH), the Canadian Association for the Study of the Liver (CASL) and the Czech Society of Hepatology (CSH). AoH publishes editorials, opinions, concise reviews, original articles, brief reports, letters to the editor, news from affiliated associations, clinical practice guidelines and summaries of congresses in the field of Hepatology.

Topics covered by AoH include alcoholic liver disease, autoimmune hepatitis, biliary diseases, drug-induced liver injury, genetic liver diseases, NAFLD/NASH and viral hepatitis (HAV, HBV, HCV, HDV, HEV). Our journal seeks to publish articles on basic clinical care and translational research focused on preventing rather than treating the complications of end-stage liver disease.

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digo.castaldelli@gmail.com

Address for correspondence Serviço de Gastroenterologia do Hospital de Clínicas de Porto Alegre. Rua Ramiro Barcelos, n° 2350/ sala 2033, 2° andar. CEP 90035-903, Bairro Santana, Porto Alegre, Rio Grande do Sul (RS) – Brazil. Corresponding author, Rodrigo Dorelo, MD, Assistant Professor, Department of Gastroenterology, Hospital de Clínicas, Av. Italia S/n CP, 11600, Montevideo, Uruguay. Phone: +598-2-4808472; Fax: +598-24872572

, Samantha T.A. Barcelos2,5, Magela Barros1,5, Valeria Elustondo1,5, Ysela Y.P. Pérez2,5, Martin Oricchio1,5, Nelson D.S. Uribe2,5, Nelia Hernandez1, Dvora Joveleviths2, Mário R. Álvares-da-Silva2,3,4,5

1 Department of Gastroenterology, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay

2 Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil

3 Experimental Laboratory of Hepatology and Gastroenterology, Center for Experimental Research, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

4 Division of Gastroenterology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil

5 World Gastroenterology Organization Porto Alegre Hepatology Training Center, Porto Alegre, RS, Brazil

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Tables (1)

TABLE 1. Baseline characteristics of all patients, cause of chronic liver disease and drugs.

Special issue

This article is part of special issue:

Vol. 24. Issue S1

Abstracts of the 2021 Annual meeting of the ALEH (Asociación Latinoamericana para el Estudio del Hígado)

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Introduction and Aim

Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially hepatotoxic drugs (PHD) in patients with CLD in a tertiary university hospital.

Materials and Method

Adult (≥ 18 years-old) with CLD admitted to the hospital from January 2016 to December 2018 were evaluated regarding PHD, assessing the risk of DILI and liver enzymes behavior after exposure.

Results

From 931 hospitalized patients with CLD, 291 (31.3%) were exposed to hepatotoxic drugs during their hospitalization. Of those, 244 (83.8%) were cirrhotic. The most frequent causes of liver disease were hepatitis C (41.2%), followed by alcohol (13.2%), hepatitis C/alcohol (11.7%) and non-alcoholic fatty liver disease (5.8%). Decompensated cirrhosis (46.7%) was the main reason for hospital admission. The most often prescribed PHD were antibiotics (67.7%), cardiovascular drugs (34.4%), neuromodulators (26.1%) and anesthetics (19.9%). After exposure, 113 patients (38.8%) presented significant elevated liver enzymes. Surprisingly, PHD were more often prescribed in GI/Liver unit (48.8%) followed by emergency/intensive care unit (28.5%). A total of 65 patients (22%) died, however in neither case was it possible to safely infer causal relationship among PHD, liver enzymes and death.

Conclusion

PHD prescription is frequent in patients with CLD even in a tertiary university hospital and in the gastroenterology and hepatology department, exposing these patients to an additional risk.

Conflict of interest statement

The authors have nothing to disclose.

Keywords:

Liver diseases

drug-induced liver injury

acute-on-chronic liver failure

acute liver failure

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