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Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study
OBJECTIVE: Identification of drug-induced liver disease (DILI) is difficult, even among hospitalized patients. The aim of this pilot study was to assess the impact of a specific strategy for DILI screening. DESIGN: We prospectively compared the number of acute DILI cases identified in one week of a...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419230/ https://www.ncbi.nlm.nih.gov/pubmed/22905129 http://dx.doi.org/10.1371/journal.pone.0042418 |
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author | M'Kada, Helmi Perazzo, Hugo Munteanu, Mona Ngo, Yen Ramanujam, Nittia Fautrel, Bruno Imbert-Bismut, Françoise Ratziu, Vlad Schuppe-Koistinen, Ina Leblond, Véronique Delattre, Jean Yves Samson, Yves Caen, Olivier Lyon Bricaire, François Khayat, David Pierrot-Deseilligny, Charles Herson, Serge Amoura, Zahir Tilleul, Patrick Deckmyn, Olivier Coriat, Pierre Delpech, Vincent Nicolas Boulogne, Philippe Bonnefont-Rousselot, Dominique Poynard, Thierry |
author_facet | M'Kada, Helmi Perazzo, Hugo Munteanu, Mona Ngo, Yen Ramanujam, Nittia Fautrel, Bruno Imbert-Bismut, Françoise Ratziu, Vlad Schuppe-Koistinen, Ina Leblond, Véronique Delattre, Jean Yves Samson, Yves Caen, Olivier Lyon Bricaire, François Khayat, David Pierrot-Deseilligny, Charles Herson, Serge Amoura, Zahir Tilleul, Patrick Deckmyn, Olivier Coriat, Pierre Delpech, Vincent Nicolas Boulogne, Philippe Bonnefont-Rousselot, Dominique Poynard, Thierry |
author_sort | M'Kada, Helmi |
collection | PubMed |
description | OBJECTIVE: Identification of drug-induced liver disease (DILI) is difficult, even among hospitalized patients. The aim of this pilot study was to assess the impact of a specific strategy for DILI screening. DESIGN: We prospectively compared the number of acute DILI cases identified in one week of a proactive strategy based on centralized elevated ALT values to those identified with a standard of care strategy for 24-week period based on referral cases to the hepatology unit. In the centralized strategy, a designated study biochemist identified patients with ALT greater than 3 times the upper limit of normal values (ULN) and notified the designated hepatologists, who then went to the patients' wards, analyzed the charts, and if necessary, interviewed the identified patients. During these two periods, patients with possible DILI were included after signing an informed consent in an ongoing European diagnostic study (SAFE-T consortium). RESULTS: During the 24-week period of the standard strategy, 12 (0.04%) patients out of a total of 28,145 were identified as having possible DILI, and 11 of these accepted to be included in the protocol. During the one-week proactive period, 7 patients out of a total of 1407 inpatients (0.498%) [odds ratio vs. standard = 12.1 (95% CI, 3.9–32.3); P<0.0001] were identified with possible DILI, and 5 were included in the protocol. CONCLUSION: A simple strategy based on the daily analysis of cases with ALT >3 ULN by designated biochemists and hepatologists identified 12 times more acute cases of drug-induced liver disease than the standard strategy. This pilot cohort is registered on the number AP-HP P110201/1/08-03-2011 and AFSSAPS B110346-70. |
format | Online Article Text |
id | pubmed-3419230 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-34192302012-08-19 Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study M'Kada, Helmi Perazzo, Hugo Munteanu, Mona Ngo, Yen Ramanujam, Nittia Fautrel, Bruno Imbert-Bismut, Françoise Ratziu, Vlad Schuppe-Koistinen, Ina Leblond, Véronique Delattre, Jean Yves Samson, Yves Caen, Olivier Lyon Bricaire, François Khayat, David Pierrot-Deseilligny, Charles Herson, Serge Amoura, Zahir Tilleul, Patrick Deckmyn, Olivier Coriat, Pierre Delpech, Vincent Nicolas Boulogne, Philippe Bonnefont-Rousselot, Dominique Poynard, Thierry PLoS One Research Article OBJECTIVE: Identification of drug-induced liver disease (DILI) is difficult, even among hospitalized patients. The aim of this pilot study was to assess the impact of a specific strategy for DILI screening. DESIGN: We prospectively compared the number of acute DILI cases identified in one week of a proactive strategy based on centralized elevated ALT values to those identified with a standard of care strategy for 24-week period based on referral cases to the hepatology unit. In the centralized strategy, a designated study biochemist identified patients with ALT greater than 3 times the upper limit of normal values (ULN) and notified the designated hepatologists, who then went to the patients' wards, analyzed the charts, and if necessary, interviewed the identified patients. During these two periods, patients with possible DILI were included after signing an informed consent in an ongoing European diagnostic study (SAFE-T consortium). RESULTS: During the 24-week period of the standard strategy, 12 (0.04%) patients out of a total of 28,145 were identified as having possible DILI, and 11 of these accepted to be included in the protocol. During the one-week proactive period, 7 patients out of a total of 1407 inpatients (0.498%) [odds ratio vs. standard = 12.1 (95% CI, 3.9–32.3); P<0.0001] were identified with possible DILI, and 5 were included in the protocol. CONCLUSION: A simple strategy based on the daily analysis of cases with ALT >3 ULN by designated biochemists and hepatologists identified 12 times more acute cases of drug-induced liver disease than the standard strategy. This pilot cohort is registered on the number AP-HP P110201/1/08-03-2011 and AFSSAPS B110346-70. Public Library of Science 2012-08-14 /pmc/articles/PMC3419230/ /pubmed/22905129 http://dx.doi.org/10.1371/journal.pone.0042418 Text en © 2012 M'Kada et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article M'Kada, Helmi Perazzo, Hugo Munteanu, Mona Ngo, Yen Ramanujam, Nittia Fautrel, Bruno Imbert-Bismut, Françoise Ratziu, Vlad Schuppe-Koistinen, Ina Leblond, Véronique Delattre, Jean Yves Samson, Yves Caen, Olivier Lyon Bricaire, François Khayat, David Pierrot-Deseilligny, Charles Herson, Serge Amoura, Zahir Tilleul, Patrick Deckmyn, Olivier Coriat, Pierre Delpech, Vincent Nicolas Boulogne, Philippe Bonnefont-Rousselot, Dominique Poynard, Thierry Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study |
title | Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study |
title_full | Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study |
title_fullStr | Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study |
title_full_unstemmed | Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study |
title_short | Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study |
title_sort | real time identification of drug-induced liver injury (dili) through daily screening of alt results: a prospective pilot cohort study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3419230/ https://www.ncbi.nlm.nih.gov/pubmed/22905129 http://dx.doi.org/10.1371/journal.pone.0042418 |
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