Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update

Yimin Mao; Shiwu Ma; Chenghai Liu; Xiaoyan Liu; Minghua Su; Dongliang Li; Yiling Li; Gongying Chen; Jun Chen; Jinjun Chen; Jingmin Zhao; Xiaoyan Guo; Jieting Tang; Yuzheng Zhuge; Qing Xie; Wen Xie; Rongtao Lai; Dachuan Cai; Qingxian Cai; Yang Zhi; Xiaoyun Li; Technology Committee on DILI Prevention, Management, Chinese Medical Biotechnology Association; Study Group on Drug-Induced Liver Disease, Chinese Society of Hepatology, Chinese Medical Association

doi:10.1007/s12072-023-10633-7

Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update

Hepatol Int. 2024 Apr;18(2):384-419. doi: 10.1007/s12072-023-10633-7. Epub 2024 Feb 24.

Authors

Yimin Mao¹, Shiwu Ma², Chenghai Liu³, Xiaoyan Liu⁴, Minghua Su⁵, Dongliang Li⁶, Yiling Li⁷, Gongying Chen⁸, Jun Chen⁹, Jinjun Chen¹⁰, Jingmin Zhao¹¹, Xiaoyan Guo¹², Jieting Tang¹³, Yuzheng Zhuge¹⁴, Qing Xie¹⁵, Wen Xie¹⁶, Rongtao Lai¹⁵, Dachuan Cai¹⁷, Qingxian Cai⁹, Yang Zhi¹³, Xiaoyun Li¹³; Technology Committee on DILI Prevention, Management, Chinese Medical Biotechnology Association; Study Group on Drug-Induced Liver Disease, Chinese Society of Hepatology, Chinese Medical Association

Affiliations

¹ Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, 200001, China. maoym11968@163.com.
² Department of Infectious Diseases, The 920th Hospital of Chinese PLA Joint Logistics Support Force, Kunming, 650032, Yunnan, China.
³ Institute of Liver Diseases, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
⁴ Department of Pharmacy, Huangpu Branch of the 9th People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 200011, China.
⁵ Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
⁶ Department of Hepatobiliary Medicine, The 900th Hospital of Chinese PLA Joint Logistics Support Force, Fuzhou, 350025, Fujian, China.
⁷ Department of Gastroenterology, First Affiliated Hospital of China Medical University, Shenyang, 110001, Liaoning, China.
⁸ Department of Liver Diseases, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, 310015, Zhejiang, China.
⁹ Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, 518112, Guangdong, China.
¹⁰ Hepatology Center, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China.
¹¹ Department of Pathology and Hepatology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100039, China.
¹² Department of Gastroenterology, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
¹³ Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, NHC Key Laboratory of Digestive Diseases, Shanghai Research Center of Fatty Liver Disease, Shanghai, 200001, China.
¹⁴ Department of Gastroenterology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, 210008, Jiangsu, China.
¹⁵ Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
¹⁶ Center of Liver Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, 100088, China.
¹⁷ Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China.

PMID: 38402364
DOI: 10.1007/s12072-023-10633-7

Abstract

Drug-induced liver injury (DILI) is an important adverse drug reaction that can lead to acute liver failure or even death in severe cases. Currently, the diagnosis of DILI still follows the strategy of exclusion. Therefore, a detailed history taking and a thorough and careful exclusion of other potential causes of liver injury is the key to correct diagnosis. This guideline was developed based on evidence-based medicine provided by the latest research advances and aims to provide professional guidance to clinicians on how to identify suspected DILI timely and standardize the diagnosis and management in clinical practice. Based on the clinical settings in China, the guideline also specifically focused on DILI in chronic liver disease, drug-induced viral hepatitis reactivation, common causing agents of DILI (herbal and dietary supplements, anti-tuberculosis drugs, and antineoplastic drugs), and signal of DILI in clinical trials and its assessment.

Keywords: Diagnosis; Drug; Guideline; Herbal and dietary supplements; Liver injury; Management; Phenotypes; Prevention; Prognosis; Treatment.

Publication types

Editorial

MeSH terms

Antineoplastic Agents*
Chemical and Drug Induced Liver Injury* / diagnosis
Chemical and Drug Induced Liver Injury* / therapy
China
Humans
Liver Failure, Acute*
Risk Factors

Substances

Antineoplastic Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding