Therapeutic Strategies for Drug-Induced Liver Injury: Review of the Current Literature

Idiosyncratic drug‐induced liver injury (DILI), as opposed to intrinsic DILI, is an unexpected adverse drug reaction that occurs at therapeutical doses of drugs, presumably due to interactions between drug properties and host factors. DILI is a challenge for clinicians, the pharmaceutical industry, and regulatory agencies. Idiosyncratic DILI was the cause of acute liver failure in 13%–15% of cases in reports from the United States and Sweden. The spontaneous survival for patients with acute liver failure owing to idiosyncratic drug reactions is usually poor, with 60%–80% mortality without liver transplantation. From a therapeutic standpoint, DILI is an orphan disease so far and, hence, its management is based on the withdrawal of the responsible drug with liver transplantation as an option for more severe/fulminant cases. Although studies assessing the role of some drugs in DILI have been published, most of them are retrospective analysis of clinical reports/case series and, indeed, very few properly designed clinical trials.

Many drugs have been used in DILI treatment without a clear evidence of eficacy. However, in most published studies, proper conclusions on the role of a given drug in preventing or treating DILI cannot be drawn because of the limitations of the design used as well as the small sample size.
The aim of this Research Topic is to carry out an in-depth review of the literature to investigate the the role of every agent (marketed drug as well as novel therapies), which has been used in treating and preventing DILI. This collection of articles will serve as the basis of well new designed randomized clinical trial for DILI management.

This Research Topic will include studies addressing the role of drugs in the treatment and prevention of DILI and will welcome Original Clinical Research,Review articles, Systematic Reviews, and meta-analysis. Some proposed themes are:

1. Management of DILI.
2. Treatment with corticosteroids in Drug-induced liver injury.
3. Role of ursodeoxycholic acid in treating and preventing drug-induced liver injury. A systematic review.
4. Use of N-Acetylcysteine in non-paracetamol drug induced Acute Liver Failure: a systematic review.
5. N-acetylcysteine for Acetaminophen Drug-induced Liver Injury: a Systematic Review of Observational Studies.
6. Novel therapies for the treatment of DILI: a systematic review of the literature.
7. Drug-induced liver injury in pediatric population: a systematic review.

---

This Research Topic is an initiative linked to the Cost Action CA17112 - Prospective European Drug-induced Liver Injury Network.

---