We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Therapeutic Management of Idiosyncratic Drug-Induced Liver Injury and Acetaminophen Hepatotoxicity in the Paediatric Population: A Systematic Review.
- Authors
Niu, Hao; Atallah, Edmond; Alvarez-Alvarez, Ismael; Medina-Caliz, Inmaculada; Aithal, Guruprasad P.; Arikan, Cigdem; Andrade, Raul J.; Lucena, M. Isabel
- Abstract
<bold>Introduction: </bold>Drug-induced liver injury (DILI) is a rare but serious adverse event that can progress to acute liver failure (ALF). The evidence for treatment of DILI in children is scarce.<bold>Objective: </bold>We aimed to comprehensively review the available literature on the therapies for both acetaminophen overdose (APAP) and idiosyncratic DILI in the paediatric population.<bold>Methods: </bold>We included original articles conducted in a paediatric population (< 18 years) in which a therapeutic intervention was described to manage APAP or idiosyncratic DILI. Findings were summarized based on age groups (preterm newborn neonates, term and post-term neonates, infants, children and adolescents).<bold>Results: </bold>Overall, 25 publications (fifteen case reports, six case series and four retrospective cohort studies) were included, including a total of 140 paediatric DILI cases, from preterm newborn neonates to adolescents. N-acetylcysteine was used to treat 19 APAP cases. N-acetylcysteine (n = 14), ursodeoxycholic acid (n = 3), corticosteroids (n = 31), carnitine (n = 16) and the combination of glycyrrhizin, reduced glutathione, polyene phosphatidylcholine and S-adenosylmethionine (n = 31) were the therapeutic options for treating idiosyncratic DILI. The molecular adsorbent recirculating system was used in the management of either APAP (n = 4) or idiosyncratic DILI (n = 2), while 20 paediatric ALF cases received continuous renal replacement therapy.<bold>Conclusions: </bold>This systematic review identified DILI in the paediatric population who have received specific treatment. These interventions appear to be mainly extrapolated from low-quality evidence from the adult population. Thus, there is a need for high-quality studies to test the efficacy of known and novel therapies to treat DILI specifically addressed to the paediatric population. PROSPERO registration number CRD42021214702.
- Subjects
ACETYLCYSTEINE; GLUTATHIONE; FERRANS &; Powers Quality of Life Index; CARNITINE; ADRENOCORTICAL hormones; ACETAMINOPHEN; LIVER; RETROSPECTIVE studies; HYDROCARBONS; BILE acids; RESEARCH funding; DRUG side effects; ACUTE diseases; LIVER failure; ADENOSYLMETHIONINE
- Publication
Drug Safety, 2022, Vol 45, Issue 11, p1329
- ISSN
0114-5916
- Publication type
journal article
- DOI
10.1007/s40264-022-01224-w