ArticleThe American journal of gastroenterology2016
Clinical Features and Outcomes of Complementary and Alternative Medicine Induced Acute Liver Failure and Injury.
Article in The American journal of gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00518440 (A Multi-Center Trial to Study Acute Liver Failure in Adults), which is not on this map. Cited by 46 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-Center Trial to Study Acute Liver Failure in Adults
Who cites it
46 citing papers in PubMed, 1 synthesis or guideline pooled it, 120 citations in OpenAlex.
- Natural products and dietary interventions on liver enzymes: an umbrella review and evidence map.Frontiers in nutrition · 2024Pooled it
- Complementary and Alternative Medicine-Induced Combined Hepatorenal Toxicity: A Case Report.Cureus · 2025Article
- Article
- Natural History of Idiosyncratic Drug-Induced Liver Injury and Prognostic Models.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Cellular Metabolomics Reveals Differences in the Scope of Liver Protection Between Ammonium-Based Glycyrrhizinate and Magnesium Isoglycyrrhizinate.Metabolites · 2025Article
- Challenges in herbal-induced liver injury identification and prevention.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Genetic Variants of GBP4: Reduced Risks for Drug-Induced Acute Liver Failure in Non-Finnish European Population.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- Identification of Genetic Risk Factors Associated With Herbal and Dietary Supplement-Induced Acute Liver Failure Using Whole Exome Sequencing Analysis.Gastro hep advances · 2025Article
- Hepsin as a potential therapeutic target for alleviating acetaminophen-induced hepatotoxicity via gap-junction regulation and oxidative stress modulation.Cell biology and toxicology · 2024Article
- Estimated Exposure to 6 Potentially Hepatotoxic Botanicals in US Adults.JAMA network open · 2024Article
- Complementary and alternative medicines and liver disease.Hepatology communications · 2024Review
- Drug-Induced Liver Injury in the Elderly: Consensus Statements and Recommendations from the IQ-DILI Initiative.Drug safety · 2024Article
- Clinical characteristics and prognosis of non-APAP drug-induced acute liver failure: a large multicenter cohort study.Hepatology international · 2024Article
- Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children: A prospective cohort study.PloS one · 2024Article
- Drug induced autoimmune hepatitis: An unfortunate case of herbal toxicity from Skullcap supplement: A case report.World journal of hepatology · 2023Article
- Advances in the study of acetaminophen-induced liver injury.Frontiers in pharmacology · 2023Review
- Article
- Prevalence, severity, duration and resolution of cholestasis after acute liver failure.BMJ open gastroenterology · 2022Article
- Secular Trends in Severe Idiosyncratic Drug-Induced Liver Injury in North America: An Update From the Acute Liver Failure Study Group Registry.The American journal of gastroenterology · 2022Article
- Complementary and alternative medicine use among older adults with musculoskeletal pain: findings from the European Social Survey (2014) special module on the social determinants of health.British journal of pain · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 5 institutions in 1 country.
Funding
Abstract
objectivesThe increasing use of complementary and alternative medicines (CAMs) has been associated with a rising incidence of CAM-induced drug-induced liver injury (DILI). The aim of this study was to examine the clinical features and outcomes among patients with acute liver failure (ALF) and acute liver injury (ALI) enrolled in the Acute Liver Failure Study Group database, comparing CAM-induced with prescription medicine (PM)-induced DILI.
methodsA total of 2,626 hospitalized patients with ALF/ALI of any etiology were prospectively enrolled between 1998 and 2015 from 32 academic transplant centers. Only those with CAM or PM-induced ALI/ALF were selected for analysis.
resultsA total of 253 (9.6%) subjects were found to have idiosyncratic DILI, of which 41 (16.3%) were from CAM and 210 (83.7%) were due to PM. The fraction of DILI-ALF/ALI cases due to CAM increased from 1998-2007 to 2007-2015 (12.4 vs. 21.1%, P=0.047). There was no difference in the type of liver injury-hepatocellular, cholestatic, or mixed-between groups as determined by R score (P=0.26). PM-induced DILI showed higher serum alkaline phosphatase levels compared with the CAM group (median IU/L, 171 vs. 125, P=0.003). The CAM population had fewer comorbid conditions (1.0 vs. 2.0, P<0.005), higher transplantation rates (56 vs. 32%, P<0.005), and a lower ALF-specific 21-day transplant-free survival (17 vs. 34%, P=0.044).
conclusionsCAM-induced DILI is at least as severe in presentation as that observed due to PM with higher rates of transplantation and lower transplant-free survival in those who progress to ALF. This study highlights the increasing incidence of CAM-induced liver injury and emphasizes the importance of early referral and evaluation for liver transplantation when CAM-induced liver injury is suspected.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.