A recent study has introduced a new way to assess the risk of liver injury caused by medications by analyzing real-world health care data. The traditional method of relying on individual reported cases of acute liver injury (ALI) was found to be inadequate in determining the actual hepatoxicity of certain medications. Researchers from the Perelman School of Medicine at the University of Pennsylvania conducted this study, which was published in JAMA Internal Medicine.
The study revealed that some medications’ liver toxicity levels were inaccurately classified based on case counts of ALI. By calculating rates of severe ALI events per 10,000 “person-years,” the researchers identified 17 medications with higher toxicity levels than initially perceived. These findings challenge the conventional approach of assessing drug-induced liver injury based solely on reported cases.
Dr. Vincent Lo Re, the senior author of the study, emphasized the importance of considering incidence rates when evaluating medication-induced liver damage. Incidence rates provide a more comprehensive view of the actual risk of liver injury by taking into account the number of people exposed to a medication over time, rather than just focusing on case reports.
The study analyzed data from nearly 8 million individuals without pre-existing liver conditions who were prescribed 194 medications known to potentially harm the liver. By comparing traditional case counts with incidence rates, the researchers uncovered discrepancies in the classification of certain medications’ hepatotoxicity.
On one hand, there were medications classified as highly hepatotoxic based on case reports but demonstrated low incidence rates of severe ALI per person-year. Conversely, some medications previously regarded as having low liver toxicity based on case counts were found to have higher incidence rates of liver injury, indicating a need for reevaluation.
Dr. Lo Re highlighted the significance of incorporating this novel approach into clinical practice to improve patient monitoring during medication use. By leveraging electronic medical records to identify high-risk medications, clinicians can implement proactive measures to safeguard patients against liver toxicity.
Furthermore, the study’s methodology could serve as a valuable tool for regulatory agencies and the pharmaceutical industry to systematically investigate reports of drug-induced liver injury on a larger scale, facilitating a more comprehensive understanding of medication safety.
