Clinical characteristics of drug-induced liver injury in the elderly

The average age of Japanese patients with drug-induced liver injury (DILI) is expected to rise as the population ages. The aim of this study was to evaluate the clinical characteristics of DILI in elderly Japanese subjects. A total of 142 hospitalized patients with DILI were divided into three groups by age (Group A, < 65 years; Group B, 65-74 years; Group C, >= 75 years). Patients were examined retrospectively with regard to the number of concomitant drugs, duration of drug intake until onset of DILI, clinical types of DILI, treatment, prognosis, and scores on the diagnostic scale described by Digestive Disease Week, Japan 2004. Patients in Group C used more concomitant drugs (P = 0.0019) compared with patients in Group A. The elderly had a higher frequency of unclear duration of drug intake (P = 0.0020), were more likely to experience cholestatic type DILI (P = 0.033), and underwent more intensive treatment for DILI (P = 0.011). There were fewer cases diagnosed as a "high possibility" of DILI in Group C compared with Group A (P = 0.030) and Group B (P = 0.013). In cases diagnosed as "possible" or "low possibility" of DILI, unclear duration of drug intake was more frequently observed in the elderly (P = 0.0027). Elderly patients with DILI show different clinical features than younger patients with DILI. These features should be taken into account in the diagnosis and treatment of DILI in the elderly.