11 research outputs found
Performances of DILI-ActiTest, apoA1 and haptoglobin, for the prediction of recovery.
<p>DILI-ActiTest ‘s AUROC = 0.723 (95%CI 0.610–0.806 P<0.001 vs. 0.5). The AUROCs of APOA1, and HAPTO were 0.663 (0.536–0.76; P = 0.004 vs 0.5; P = 0.14 vs DILI-ActiTest), and 0.619 (0.496–0.718; P = 0.04 vs 0.500; p = 0.05 vs DILI-ActiTest).</p
Summary of significant (Bonferroni) differences of baseline test medians according to drugs, n = 154.
<p>Summary of significant (Bonferroni) differences of baseline test medians according to drugs, n = 154.</p
Prediction of recovery at inclusion, in adjudicated DILI cases (n = 115).
<p>Prediction of recovery at inclusion, in adjudicated DILI cases (n = 115).</p
Characteristics of patients adjudicated as DILI or not, among the population suspected cases, the context of use population (n = 176).
<p>Characteristics of patients adjudicated as DILI or not, among the population suspected cases, the context of use population (n = 176).</p
Flow chart of patients included and analyzed.
<p>Flow chart of patients included and analyzed.</p
Performances of DILI-ActiTest, apoA1 and haptoglobin, for the prediction of recovery.
<p>DILI-ActiTest ‘s AUROC = 0.723 (95%CI 0.610–0.806 P<0.001 vs. 0.5). The AUROCs of APOA1, and HAPTO were 0.663 (0.536–0.76; P = 0.004 vs 0.5; P = 0.14 vs DILI-ActiTest), and 0.619 (0.496–0.718; P = 0.04 vs 0.500; p = 0.05 vs DILI-ActiTest).</p
Real Time Identification of Drug-Induced Liver Injury (DILI) through Daily Screening of ALT Results: A Prospective Pilot Cohort Study
<div><h3>Objective</h3><p>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.</p> <h3>Design</h3><p>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).</p> <h3>Results</h3><p>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.</p> <h3>Conclusion</h3><p>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.</p> <p>This pilot cohort is registered on the number AP-HP P110201/1/08-03-2011 and AFSSAPS B110346-70.</p> </div
Characteristics of patients with DILI according to the screening period.
*<p>P<0.001 Hy's criteria ALT >3ULN and total bilirubin >31 micromol/L.</p
Flowchart of the identification of DILI during the centralized period in 1995 patients with ALT measurement.
<p>Flowchart of the identification of DILI during the centralized period in 1995 patients with ALT measurement.</p
Characteristics of patients analyzed during the centralized period.
<p>Characteristics of patients analyzed during the centralized period.</p