Drug- and herb-induced liver injury:Progress,current challenges and emerging signals of post-marketi

来源 :World Journal of Hepatology | 被引量 : 0次 | 上传用户:guqiurong
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
Drug-induced liver injury(DILI) and herb-induced liver injury is a hot topic for clinicians,academia,drug companies and regulators,as shown by the steadily increasing number of publications in the past 15 years.This review will first provide clues for clinicians to suspect idiosyncratic(unpredictable) DILI and succeed in diagnosis.Causality assessment remains challenging and requires careful medical history as well as awareness of multifaceted aspects,especially for herbs.Drug discontinuation and therapy reconciliation remain the mainstay in patent’s management to minimize occurrence of acute liver failure.The second section will address novel agents associated with liver injury in 2014(referred to as “signals”),especially in terms of clinical,research and drug development implications.Insights will be provided into recent trends by highlighting the contribution of different post-marketing data,especially registries and spontaneous reporting systems.This literature scrutiny suggests:(1) the importance of postmarketing databases as tools of clinical evidence to detect signals of DILI risk;and(2) the need for joining efforts in improving predictivity of pre-clinical assays,continuing post-marketing surveillance and design ad hoc post-authorization safety studies.In this context,ongoing European/United States research consortia and novel pharmaco-epidemiological tools(e.g.,specialist prescription event monitoring) will support innovation in this field.Direct oral anticoagulants and herbal/dietary supplements appear as key research priorities. Drug-induced liver injury (DILI) and herb-induced liver injury is a hot topic for clinicians, academia, drug companies and regulators, as shown by the steadily increasing number of publications in the past 15 years. This review will first provide clues for clinicians to suspect idiosyncratic (unpredictable) DILI and succeed in diagnosis. Causality assessment yet challenging and not careful medical history as well as awareness of multifaceted aspects, especially for herbs. Drug discontinuation and therapy reconciliation remain the mainstay in patent’s management to minimize occurrence of acute liver failure. The second section will address novel agents associated with liver injury in 2014 (referred to as “signals ”), especially in terms of clinical, research and drug development implications. Insights will be provided into recent trends by highlighting the contribution of different post-marketing data, especially registries and spontaneous reporting systems. This literature scrutiny suggests: (1) the importance of postmarketing databases as tools of clinical evidence to detect signals of DILI risk; and (2) the need for joining efforts in improving predictivity of pre-clinical assays, continuing post-marketing surveillance and design ad hoc post-authorization safety studies.In this context, ongoing European / United States research consortia and novel pharmaco-epidemiological tools (eg, specialist prescription event monitoring) will support innovation in this field. Direct oral anticoagulants and herbal / dietary supplements appear as key research priorities.
其他文献
Objective: To investigate the ef ect of intra-peritoneal injection of purii ed exudates of axenic Spirulina platensis on the mammalian endocrine and nervous sys
OBJECTIVE To construct an integrative database for multi-compound drug discovery.METHODS We designed and constructed a database system,which integrates traditio
阿拉伯有一个民间传说:阿里巴巴无意中发现了强盗的秘密,念几句“芝麻开门”咒语,强盗藏宝洞的大门就会自动打开。   阿里巴巴是个幸运人物。现实中,很多人都想这样幸运,谁不想
弧焊电源使用和维修培训班在成都电焊机研究所举办[本刊讯]近年来,在广大用户的支持下,成都电焊机研究所向各界用户提供了大批高效、节能的新型焊接设备,且产量和销售形势呈年年上
本文报告儿科1985年3岁以内住院患儿380人,其中患有VitD 缺乏症者90人,占23.68%;新生儿63人,发现先天性佝偻病2例,患病率为3.2%.90例VitD 缺乏症并存的儿科疾病最多者为肺炎4
一般人们都会说,不后悔自己的选择。或者如果重来一遍,还是选择已经走过的这条。然而我却对此抱有迟疑。一个人不可能永远正确,很多行动或决定,与其说是主动选择的,不如说是
2009年,女儿女婿因煤气中毒猝然离世,让盛海琳无比痛心,甚至有了追随女儿离去的念头。一个生试管婴儿的建议提醒了她,学医出身的盛海琳决定实施自己的孕育计划。要想圆花甲之
如何加强基层医疗卫生机构建设,充分发挥在新医改中的作用,作者总结了当前基层医疗机构存在的一些问题,从加大规划建设力度,注重投入;加强队伍建设,人才培养,注重考核奖惩;加
文化大革命期间,有一项革命措施,让“革命群众”住进“资产阶级权威”的家里去。据我后来得知,这叫“掺沙子”。“沙子”其实只是需要住房的人,政治面貌和表现各各不同。1969年5月间,锺
病历摘要例1.男,1小时。第1胎第1产,足月顺产。出生后即发现全身皮肤如蒙上一层棕黄色羊皮纸样包膜。母妊娠期间身体健康,未用任何药物。家族中无类似病史。体检:发育营养一