Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study.
To access publisher's full text version of this article click on the hyperlink below Background: There is limited information on the frequency of idiosyncratic drug-liver injury (DILI) among cancer patients. The aim of the study was to evaluate the frequency of DILI due to cancer treatment in a...
Published in: | Scandinavian Journal of Gastroenterology |
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Taylor & Francis
2022
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Online Access: | http://hdl.handle.net/2336/622126 https://doi.org/10.1080/00365521.2022.2038260 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/622126 2023-05-15T16:49:06+02:00 Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study. Björnsson, H K Sverrisdottir, A Björnsson, E S 1Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 2Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg, Sweden. 3Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 4Department of Oncology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 2022-03 http://hdl.handle.net/2336/622126 https://doi.org/10.1080/00365521.2022.2038260 en eng Taylor & Francis https://www.tandfonline.com/doi/full/10.1080/00365521.2022.2038260 Björnsson HK, Sverrisdottir A, Björnsson ES. Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study [published online ahead of print, 2022 Feb 9]. Scand J Gastroenterol. 2022;1-6. doi:10.1080/00365521.2022.2038260 35138984 doi:10.1080/00365521.2022.2038260 http://hdl.handle.net/2336/622126 1502-7708 Scandinavian journal of gastroenterology Landspitali Access - LSH-aðgangur Scandinavian journal of gastroenterology 1 6 England DILI RUCAM hepatotoxicity liver enzymes malignancy Lifrarsjúkdómar Lyfjameðferð Krabbamein Liver Diseases Chemical and Drug Induced Liver Injury Drug Therapy Neoplasms Article 2022 ftlandspitaliuni https://doi.org/10.1080/00365521.2022.2038260 2022-05-29T08:22:42Z To access publisher's full text version of this article click on the hyperlink below Background: There is limited information on the frequency of idiosyncratic drug-liver injury (DILI) among cancer patients. The aim of the study was to evaluate the frequency of DILI due to cancer treatment in a population-based setting. Material and methods: All patients diagnosed with genitourinary cancer, breast cancer or metastatic malignant melanoma in 2007-2018 were matched with a database containing laboratory results for all major hospitals in Iceland. Medical chart review was performed for cases with ALT/AST ≥5× upper limit of normal (ULN), ALP ≥2× ULN or bilirubin ≥2× ULN. Patients with liver-, and/or bone metastases and isolated elevations of ALP and patients with other etiologies of liver enzyme elevations were excluded. Cases with a RUCAM score of probable or highly probable were included. Results: Among 4956 patients, 840 patients had liver enzyme elevations. Overall, nine (0.2%) cases of DILI were identified, seven women (78%), median age 59 years (IQR 52-66). Four patients had kidney cancer, four breast cancer and one metastatic prostate cancer. In eight cases, a single agent was implicated: Pazopanib (n = 3), axitinib, docetaxel, gemcitabine, letrozole and paclitaxel. In all cases, the treatment was interrupted or discontinued due to the liver injury. No patient developed jaundice or liver failure and no death was linked to DILI. Time to normalization of liver enzymes was 17 days (IQR 25-120). Conclusion: DILI was found to be rare and no cases of severe liver injury occurred. However, approximately 90% of patients switched to another treatment which might have affected prognosis. Keywords: DILI; RUCAM; hepatotoxicity; liver enzymes; malignancy. Landspitali University Hospital Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Scandinavian Journal of Gastroenterology 1 6 |
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Open Polar |
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Hirsla - Landspítali University Hospital research archive |
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ftlandspitaliuni |
language |
English |
topic |
DILI RUCAM hepatotoxicity liver enzymes malignancy Lifrarsjúkdómar Lyfjameðferð Krabbamein Liver Diseases Chemical and Drug Induced Liver Injury Drug Therapy Neoplasms |
spellingShingle |
DILI RUCAM hepatotoxicity liver enzymes malignancy Lifrarsjúkdómar Lyfjameðferð Krabbamein Liver Diseases Chemical and Drug Induced Liver Injury Drug Therapy Neoplasms Björnsson, H K Sverrisdottir, A Björnsson, E S Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study. |
topic_facet |
DILI RUCAM hepatotoxicity liver enzymes malignancy Lifrarsjúkdómar Lyfjameðferð Krabbamein Liver Diseases Chemical and Drug Induced Liver Injury Drug Therapy Neoplasms |
description |
To access publisher's full text version of this article click on the hyperlink below Background: There is limited information on the frequency of idiosyncratic drug-liver injury (DILI) among cancer patients. The aim of the study was to evaluate the frequency of DILI due to cancer treatment in a population-based setting. Material and methods: All patients diagnosed with genitourinary cancer, breast cancer or metastatic malignant melanoma in 2007-2018 were matched with a database containing laboratory results for all major hospitals in Iceland. Medical chart review was performed for cases with ALT/AST ≥5× upper limit of normal (ULN), ALP ≥2× ULN or bilirubin ≥2× ULN. Patients with liver-, and/or bone metastases and isolated elevations of ALP and patients with other etiologies of liver enzyme elevations were excluded. Cases with a RUCAM score of probable or highly probable were included. Results: Among 4956 patients, 840 patients had liver enzyme elevations. Overall, nine (0.2%) cases of DILI were identified, seven women (78%), median age 59 years (IQR 52-66). Four patients had kidney cancer, four breast cancer and one metastatic prostate cancer. In eight cases, a single agent was implicated: Pazopanib (n = 3), axitinib, docetaxel, gemcitabine, letrozole and paclitaxel. In all cases, the treatment was interrupted or discontinued due to the liver injury. No patient developed jaundice or liver failure and no death was linked to DILI. Time to normalization of liver enzymes was 17 days (IQR 25-120). Conclusion: DILI was found to be rare and no cases of severe liver injury occurred. However, approximately 90% of patients switched to another treatment which might have affected prognosis. Keywords: DILI; RUCAM; hepatotoxicity; liver enzymes; malignancy. Landspitali University Hospital |
author2 |
1Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. 2Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg, Sweden. 3Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 4Department of Oncology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Björnsson, H K Sverrisdottir, A Björnsson, E S |
author_facet |
Björnsson, H K Sverrisdottir, A Björnsson, E S |
author_sort |
Björnsson, H K |
title |
Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study. |
title_short |
Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study. |
title_full |
Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study. |
title_fullStr |
Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study. |
title_full_unstemmed |
Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study. |
title_sort |
dili is rare amongst patients without liver metastases receiving cancer treatment in iceland: a population-based cohort study. |
publisher |
Taylor & Francis |
publishDate |
2022 |
url |
http://hdl.handle.net/2336/622126 https://doi.org/10.1080/00365521.2022.2038260 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Scandinavian journal of gastroenterology 1 6 England |
op_relation |
https://www.tandfonline.com/doi/full/10.1080/00365521.2022.2038260 Björnsson HK, Sverrisdottir A, Björnsson ES. Dili is rare amongst patients without liver metastases receiving cancer treatment in Iceland: a population-based cohort study [published online ahead of print, 2022 Feb 9]. Scand J Gastroenterol. 2022;1-6. doi:10.1080/00365521.2022.2038260 35138984 doi:10.1080/00365521.2022.2038260 http://hdl.handle.net/2336/622126 1502-7708 Scandinavian journal of gastroenterology |
op_rights |
Landspitali Access - LSH-aðgangur |
op_doi |
https://doi.org/10.1080/00365521.2022.2038260 |
container_title |
Scandinavian Journal of Gastroenterology |
container_start_page |
1 |
op_container_end_page |
6 |
_version_ |
1766039177886957568 |