Evidence map›Paper›PMID 31816676›Full record

SynthesisClinical and molecular hepatology2020

Drug induced liver injury: East versus West - a systematic review and meta-analysis.

En Xian Sarah Low, Qishi Zheng, Edwin Chan, Seng Gee Lim

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Clinical and molecular hepatology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Review
  4. Article
  5. Article
  6. Rare Case Report of Ticagrelor-Induced Hepatotoxicity.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2025
    Article
  7. Article
  8. Article
  9. Liver Function Abnormalities in Patients withInfection and drug resistance · 2025
    Article
  10. Impact of Traditional Chinese Medicine Antioxidants on Oxidative Stress and Drug-Induced Liver Injury: A Review.Medical science monitor : international medical journal of experimental and clinical research · 2024
    Review
  11. Article
  12. Regulation of Gut Microflora byInternational journal of molecular sciences · 2023
    Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Review
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

En Xian Sarah LowDivision of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore.
Qishi ZhengSingapore Clinical Research Institute, Singapore.
Edwin ChanSingapore Clinical Research Institute, Singapore.
Seng Gee LimDivision of Gastroenterology and Hepatology, Department of Medicine, National University Health System, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Drug induced liver injury (DILI) may be different in the East compared to the West due to differing disease prevalence, prescribing patterns and pharmacogenetic profiles. To review existing literature on causative agents of DILI in the East compared to the West, a comprehensive literature search was performed on electronic databases: MEDLINE/PubMed, Embase, Cochrane Library and China National Knowledge Infrastructure without language restrictions. Studies which involve patients having DILI and reported the frequency of causative agents were included. A random effects model was applied to synthesize the current evidence using prevalence of class-specific and agent-specific causative drugs with 95% confidence intervals. Of 6,914 articles found, 12 showed the distribution of drugs implicated in DILI in the East with a total of 33,294 patients and 16 in the West with a total of 26,069 DILI cases. In the East, the most common agents by class were anti-tuberculosis drugs (26.6%), herbal and alternative medications (25.3%), and antibiotics (15.7%), while in the West, antibiotics (34.9%), cardiovascular agents (17.3%), and non-steroidal anti-inflammatory drugs (12.5%) were the commonest. For individual agents, the most common agents in the East were isoniazid-rifampicin-pyrazinamide (25.4%), phenytoin (3.5%), and cephalosporin (2.9%) while in the West, amoxicillin-potassium clavulanate combination acid (11.3%), nimesulide (6.3%), and ibuprofen (6.1%) were the commonest. There was significant heterogeneity due to variability in single-centre compared to multi-centre studies. Differences in DILI in the East versus the West both in drug classes and individual agents are important for clinicians to recognize.

Indexed as

Anti-Bacterial AgentsAntitubercular AgentsCardiovascular AgentsChemical and Drug Induced Liver InjuryDatabases, FactualHumansMedicine, TraditionalRisk AssessmentAnti-Bacterial AgentsAntitubercular AgentsCardiovascular AgentsAnti-bacterial agentsAntibiotics, AntitubercularChemical and drug induced liver injury

Identifiers

PMID31816676
PMCPMC7160354

What OpenQuestion holds

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Registered trials

None linked

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.