Overview of drug induced liver injury in Brazil:What is the role of public health policy on the evidence?  

作　　者：Matheus William Becker Karin Hepp Schwambach Michele Lunardelli Carine Raquel Blatt 

机构地区：[1]Graduate Program in Medicine-Hepatology,Federal University of Health Sciences of Porto Alegre,Porto Alegre 90050-170,RS,Brazil [2]Pharmacoscience Department,Federal University of Health Sciences of Porto Alegre,Porto Alegre 90050-170,RS,Brazil

出　　处：《World Journal of Gastrointestinal Pharmacology and Therapeutics》2021年第3期40-55,共16页世界胃肠药理与治疗学杂志（英文版）（电子版）

摘　　要：BACKGROUND Adverse drug reactions are responsible for increased costs and morbidity in the health system.Hepatotoxicity can be induced both by non-prescription drugs and by those used for chronic diseases.It is the main cause of safety-related drug marketing withdrawals and could be responsible for irreversible and fatal injuries.AIM To identify and to summarize Brazilian studies reporting the drug-induced liver injury.METHODS A systematic review of Brazilian studies was carried out until June 2020.It was found 32 studies,being 10 retrospective cohorts,12 prospective cohorts,5 crosssectional,3 case-control,one case series and one randomized clinical trial.In most studies were investigated tuberculosis patients followed by other infectious conditions like human immunodeficiency virus(HIV)and hepatitis C virus.The hepatotoxicity ranged from one to 57%,led by isoniazid,rifampicin,and pyrazinamide.Few studies reported algorithm to assess causality.In most studies,there were moderate outcomes and it was necessary drug interruption.However,few severe outcomes,such as chronic liver damage and liver transplantation were reported.RESULTS Twenty-two different criteria for hepatotoxicity were found.The great heterogeneity did not allow a meta-analysis.Standardization of parameter of drug-induced liver injury and greater effort in pharmacovigilance could contribute to learn more about drug-induced liver injury(DILI)’s epidemiology in Brazil.CONCLUSION The development of strategic public health policies seems to have an influence on the DILI scientific evidence in Brazil due to main studies are in HIV and tuberculosis line care,two strategic health policies in Brazil.

关 键 词：Chemical and drug-induced liver injury PHARMACOVIGILANCE PHARMACOEPIDEMIOLOGY Adverse effects Infectious disease medicine HEPATOTOXICITY 

分 类 号：R575[医药卫生—消化系统]