The researchers, who belong to IBIMA Plataforma BIONAND, the Hospital Universitario Virgen de la Victoria, the CIBERehd and the UMA have led this study with almost a thousand patients in which they aim to reduce side effects and clinical worsening.
A groundbreaking study conducted by the research team of the Biomedical Research Institute of Malaga and Nanomedicine Platform (IBIMA Plataforma BIONAND), the Virgen de la Victoria University Hospital and the University of Malaga (UMA), has revealed that previous drug allergies are associated with poorer clinical outcomes in patients who develop drug-induced idiosyncratic liver injury (DILI).drug-induced liver injury.
Using a machine learning approach, a branch of artificial intelligence, for risk stratification, the study has recently been published in the scientific journal 'Pharmacological Research'. In addition, the research team belongs to the Biomedical Research Network on Liver and Digestive Diseases (CIBERehd) and leads at European level the European Cooperation in Science and Technology (COST) Network 'Prospective European Drug-Induced Liver Injury Network, Pro Euro DILI Network, in which 27 countries participate.
The study analysed a cohort of 912 cases of patients with drug-induced liver injury from the Spanish DILI Registry and found that 6.7% of the patients had a documented history of drug allergy. The results showed that these patients were not only older, but also had higher levels of aspartate aminotransferase (AST) - an enzyme found, among other organs, in the liver, and a marker of liver damage - a lower platelet count and a higher rate of fulminant liver failure compared to those without a history of drug allergy.
Based on this finding, we can highlight the importance of considering previous drug allergies when assessing the risk of adverse outcomes in patients with drug-induced liver injury," said Dr Hao Niu, one of the lead authors of the study. She added: "Our predictive model, which includes variables such as type of liver injury and AST and bilirubin levels, has shown excellent performance in predicting worse clinical prognosis.
Dr Ismael Álvarez, another of the lead authors, argued that "patients with suspected DILI should be evaluated for a history of drug allergy, as they would require more exhaustive monitoring for early detection of possible clinical worsening". In this sense, the researcher has also pointed out that "this study provides a solid basis for improving the clinical management and prognosis of these patients".
The team of researchers who coordinated the study belong to the 'Hepatogastroenterology, Pharmacology and Translational Clinical Therapeutics' group, led by professionals from the Virgen de la Victoria University Hospital and professors from the University of Malaga, Raúl J. Andrade and M. Isabel Lucena.
The study also identified that penicillin was the drug most commonly associated with previous allergies in patients with liver toxicity, accounting for 32% of cases. These findings are crucial for the development of clinical strategies to better identify and clinically manage at-risk patients.
In addition to IBIMA Plataforma BIONAND, the Virgen de la Victoria University Hospital and the University of Malaga, professionals from the University Hospital of Cáceres, the Faculty of Medicine of the National University of Rosario (Argentina) and the Hospital de Clínicas of the University of the Republic of Montevideo (Uruguay) have also collaborated in this study.
Raúl J. Andrade Bellido, es Investigador Responsable del grupo consolidado ‘Hepatogastroenterología, Farmacología y Terapéutica Clínica Traslacional’ de IBIMA Plataforma BIONAND, Catedrático y Director del Departamento de Medicina en la Facultad de Medicina de la Universidad de Málaga, Jefe de Servicio Aparato Digestivo del Hospital Universitario Virgen de la Victoria en Málaga. Además, es el Responsable del Grupo Español de Hepatopatias asociadas a medicamentos (Spanish DILI Registry), el Coordinador de la Red Ibero-Americana de Hepatopatías asociadas a medicamentos (SLATINDILI) y también del Registro europeo de Hepatopatías asociadas a Medicamentos (Pro-Euro DILI Registry). Chair de la COST Action CA17112 – Prospective European Drug-Induced Liver Injury Network (PRO-EURO DILI NET) y del EASL DHILI Consortium. Horizonte2020. Framework Programme (European Union).