Drug-Induced Liver Injury in the Elderly: Consensus Statements and Recommendations from the IQ-DILI Initiative

被引：6

作者：

Cohen, Eric B. ^{[1
]}

Patwardhan, Meenal ^{[1
]}

Raheja, Ritu ^{[1
]}

Alpers, David H. ^{[2
]}

Andrade, Raul J. ^{[3
]}

Avigan, Mark I. ^{[4
]}

Lewis, James H. ^{[5
]}

Rockey, Don C. ^{[6
]}

Chui, Francis ^{[7
]}

Iacob, Alexandru M. ^{[8
]}

Linardi, Camila C. ^{[9
]}

Regev, Arie ^{[10
]}

Shick, Jesse ^{[7
]}

Lucena, Maribel I. ^{[11
]}

机构：

[1] AbbVie Inc, Pharmacovigilance & Patient Safety, N Chicago, IL 60064 USA

[2] Washington Univ, Sch Med, Dept Med, St Louis, MO USA

[3] Univ Malaga, Dept Med, IBIMA Plataforma Bionand, Malaga, Spain

[4] FDA, Ctr Drug Evaluat & Res, Silver Spring, MD USA

[5] Georgetown Univ, Div Gastroenterol, Washington, DC USA

[6] Med Univ South Carolina, Digest Dis Res Ctr, Charleston, SC USA

[7] Gilead Sci Inc, Pharmacovigilance, Foster City, CA USA

[8] AbbVie Inc, Pharmacovigilance & Patient Safety, Ottawa, ON, Canada

[9] Bayer HealthCare Pharmaceut LLC, Translat Med, Whippany, NJ USA

[10] Eli Lilly & Co, Global Patient Safety, Indianapolis, IN USA

[11] Univ Malaga, Dept Pharmacol & Pediat, IBIMA Plataforma Bionand, Malaga, Spain

来源：

DRUG SAFETY | 2024年 / 47卷 / 04期

关键词：

AGE-RELATED-CHANGES; UNITED-STATES; OLDER-ADULTS; CLINICAL-FEATURES; BEERS CRITERIA; MEDICATION USE; SERUM-ALBUMIN; RISK-FACTORS; POPULATION; OUTCOMES;

D O I：

10.1007/s40264-023-01390-5

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

The elderly demographic is the fastest-growing segment of the world's population and is projected to exceed 1.5 billion people by 2050. With multimorbidity, polypharmacy, susceptibility to drug-drug interactions, and frailty as distinct risk factors, elderly patients are especially vulnerable to developing potentially life-threatening safety events such as serious forms of drug-induced liver injury (DILI). It has been a longstanding shortcoming that elderly individuals are often a vulnerable population underrepresented in clinical trials. As such, an improved understanding of DILI in the elderly is a high-priority, unmet need. This challenge is underscored by recent documents put forward by the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) that encourage data collection in the elderly and recommend improved practices that will facilitate a more inclusive approach. To establish what is already known about DILI in the elderly and pinpoint key gaps of knowledge in this arena, a working definition of "elderly" is required that accounts for both chronologic and biologic ages and varying states of frailty. In addition, it is critical to characterize the biological role of aging on liver function, as well as the different epidemiological factors such as polypharmacy and inappropriate prescribing that are common practices. While data may not show that elderly people are more susceptible to DILI, DILI due to specific drugs might be more common in this population. Improved characterization of DILI in the elderly may enhance diagnostic and prognostic capabilities and improve the way in which liver safety is monitored during clinical trials. This summary of the published literature provides a framework to understand and evaluate the risk of DILI in the elderly. Consensus statements and recommendations can help to optimize medical care and catalyze collaborations between academic clinicians, drug manufacturers, and regulatory scientists to enable the generation of high-quality research data relevant to the elderly population.

引用

页码：301 / 319

页数：19