Risk of acute liver injury associated with the use of drugs:: a multicentre population survey

被引:45
作者
Sabate, M.
Ibanez, L.
Perez, E.
Vidal, X.
Buti, M.
Xiol, X.
Mas, A.
Guarner, C.
Forne, M.
Sola, R.
Castellote, J.
Rigau, J.
Laporte, J.-R.
机构
[1] Univ Autonoma Barcelona, Hosp Gen Valle Hebron, Fdn Inst Catala Farmacol, E-08193 Barcelona, Spain
[2] Univ Autonoma Barcelona, Hosp Gen Valle Hebron, Liver Unit, E-08193 Barcelona, Spain
[3] Hosp Princeps Espanya Bellvitge, Serv Gastroenterol, Lhospitalet De Llobregat, Spain
[4] Hosp Clin Barcelona, IDIBAPS, Liver Unit, E-08036 Barcelona, Spain
[5] Hosp Santa Creu & Sant Pau, Gastroenterol Serv, E-08025 Barcelona, Spain
[6] Hosp Mutuna, Gastroenterol Serv, Terrassa, Spain
[7] Univ Autonoma Barcelona, Hosp del Mar, Liver Sect, E-08193 Barcelona, Spain
[8] Gen Hosp, Gastroenterol Serv, Granollers, Spain
关键词
D O I
10.1111/j.1365-2036.2007.03338.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Acute liver injury of uncertain aetiology is often drug related and quantitative information about the associated risk is scarce. Aim To estimate the risk of acute liver injury associated with the use of drugs. Methods In a population survey study, 126 cases of acute liver injury were prospectively assembled from January 1993 to December 1999, in patients over 15 years of age, in 12 hospitals in Barcelona (Spain). We estimated the relative risk for each drug as the ratio between the incidence of acute liver injury among the exposed population to the drug and the incidence of acute liver injury among those not exposed to it. Drug consumption data were used to estimate the exposed population. Results Isoniazid, pyrazinamide, rifampicin, amoxicillin with clavulanic acid, erythromicin, chlorpromazine, nimesulide, and ticlopidine presented the highest risk (point relative risk > 25). Amoxicillin, metoclopramide, captopril and enalapril, furosemide, hydrochlorothiazide, fluoxetine, paroxetine, diazepam, alprazolam, lorazepam, metamizole, low-dose acetylsalicylic acid and salbutamol showed the lowest risk (point relative risk < 5). Conclusions This study provides a risk estimation of serious liver disease for various drugs that will be useful in its diagnosis and management, and when comparing with the drug therapeutic benefit in each indication. Some observed associations would be worth specific studies.
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页码:1401 / 1409
页数:9
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