ArticleHepatology communications2019
A Single-Center Experience on Outcomes of Complementary and Alternative Medicine Use Among Patients With Cirrhosis.
Article in Hepatology communications, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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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.
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Who cites it
16 citing papers in PubMed, 31 citations in OpenAlex.
- Analysis of 386 alternative medicinal products implicated in liver injury reveal clinically relevant associations with potentially hepatotoxic botanicals, pharmaceutical adulteration, heavy metal contamination, and undisclosed animal content.Frontiers in gastroenterology (Lausanne, Switzerland) · 2026Article
- 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
- Article
- Drug-Induced Liver Injury in Patients With Chronic Liver Disease.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Acute-on-chronic liver failure (ACLF): the 'Kyoto Consensus'-steps from Asia.Hepatology international · 2025Review
- Liver diseases and hepatocellular carcinoma in the Asia-Pacific region: burden, trends, challenges and future directions.Nature reviews. Gastroenterology & hepatology · 2024Review
- Complementary and alternative medicines and liver disease.Hepatology communications · 2024Review
- Ayurvedic treatment induced severe alcoholic hepatitis and non-cirrhotic portal hypertension in a 14-year-old girl.Oxford medical case reports · 2022Article
- Herbal and dietary supplement-induced liver injury in Taiwan: comparison with conventional drug-induced liver injury.Hepatology international · 2021Article
- Drug-induced liver injury: Asia Pacific Association of Study of Liver consensus guidelines.Hepatology international · 2021Article
- Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs.World journal of hepatology · 2020Review
- Outcomes and Toxicology of Herbal Drugs in Alcoholic Hepatitis - A Single Center Experience from India.Journal of clinical and translational hepatology · 2019Article
- Complementary and Alternative Medicine-related Drug-induced Liver Injury in Asia.Journal of clinical and translational hepatology · 2019Review
- A Rare Cause of Acute on Chronic Liver Failure (ACLF): Bakuchi-Induced Liver Injury.Journal of clinical and experimental hepatologyArticle
- Drug-induced liver injury in patients with underlying liver disease.Clinical liver diseaseReview
- Etiological Spectrum of Cirrhosis in India: A Systematic Review and Meta-analysis.Journal of clinical and experimental hepatologyArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Drug-induced liver injury (DILI) due to complementary and alternative medicine (CAM) use is on the rise throughout the world by patients looking for "safer" alternatives. However, data on acute-on-chronic liver failure (ACLF) due to CAM are lacking. In a large cohort of patients with cirrhosis, we retrospectively studied CAM-related health-seeking behavior and attempted to identify those who developed possible CAM-DILI-related ACLF. In this study, we examine the clinical, biochemical, and liver histopathologic characteristics of possible CAM-DILI-related ACLF, describe implicated CAM agents, and discuss predictors of patient outcomes. Out of 1,666 patients with cirrhosis, 68% used CAM at some point. A total of 35.7% (n = 30/84) patients presented with CAM-related DILI leading to ACLF in the whole CAM-DILI-related decompensation cohort. The most common CAM was unlabeled polyherbal Ayurvedic formulations. Of possible patients with ACLF, 63% self-medicated with CAM based on social media sharing. Mean age ± SD was 51.9 ± 9.9 years, 83% were male patients, median follow-up duration was 173 (range, 14-584) days, median Child-Turcotte-Pugh score was 13 (range, 10-14), Model for End-Stage Liver Disease-sodium score was 30.1 ± 4.8, median chronic liver failure-organ failure (CLIF-C-OF) score was 11 (range, 8-14), and median CLIF-C-ACLF score was 98 (range, 87-127). Portal-based neutrophilic predominant mixed inflammation, hepatocyte ballooning, autoimmune-like features, and severe cholestasis were seen on liver biopsy. Overall, 53% of patients died (median survival 194 days). Baseline overt hepatic encephalopathy and CLIF-C-OF score, total bilirubin, hyponatremia and leukocytosis, and grade of ACLF predicted 1-, 3-, 6- and 12-month mortality, respectively.
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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.