Evidence map›Paper›PMID 34382132›Full record

ArticleHepatology international2021

Herbal and dietary supplement-induced liver injury in Taiwan: comparison with conventional drug-induced liver injury.

Yi-Shin Huang, Ting-Tsung Chang, Cheng-Yuan Peng, Gin-Ho Lo, Chao-Wei Hsu, Chi-Tan Hu, Yi-Hsiang Huang

Abstract read
PubMed Publisher
In one paragraph

Article in Hepatology international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 15% of its field
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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Guideline
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 1 country.

Yi-Shin HuangDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, and National Yang Ming Chiao Tung University School of Medicine, 201, Section 2, Shi-Pai Road, Taipei, 11217, Taiwan. yshuang@vghtpe.gov.tw.ORCID http://orcid.org/0000-0001-7942-2078
Ting-Tsung ChangDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Cheng-Yuan PengDepartment of Internal Medicine, Center for Digestive Medicine, China Medical University Hospital, Taichung, Taiwan.
Gin-Ho LoDepartment of Medical Research, Digestive Center, E-DA Hospital, Kaohsiung, Taiwan.
Chao-Wei HsuDepartment of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Lin-Kou, and Chang Gung University College of Medicine, Lin-Kou, Taiwan.
Chi-Tan HuDivision of Gastroenterology and Hepatology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
Yi-Hsiang HuangDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, and National Yang Ming Chiao Tung University School of Medicine, 201, Section 2, Shi-Pai Road, Taipei, 11217, Taiwan.
National Yang Ming Chiao Tung University · TWBuddhist Tzu Chi General Hospital · TWChang Gung University · TWChina Medical University · TWE-Da Hospital · TWNational Cheng Kung University Hospital · TW

Funding

FDA HHS DOH100-99TFDA-P-092FDA HHS DOH101-FDA-41103
6 · The paper itself

Abstract

BACKGROUND AND

aimsWhether herbal and dietary supplements (HDS) are safer than Western conventional drugs is controversial. The aim of this study was to explore the characteristics and risk factors for HDS-induced liver injury (HILI) in Taiwan.

methodsThis is a 9-year multi-center prospective study conducted in Taiwan from 2011 to 2019. Patients with HILI were compared to those with conventional drug-induced liver injury (CILI).

resultsA total of 1,297 patients were enrolled, of whom 285 (22.0%) had HILI and 1,012 (78.0%) had CILI. Compared to the CILI group, the HILI group had higher initial serum alanine aminotransferase, alkaline phosphatase (ALP), peak ALP and bilirubin levels, and higher rates of jaundice, ascites, encephalopathy, coagulopathy, sepsis and acute liver failure. In addition, the HILI group had a higher mortality rate than the CILI group (12.6 vs. 8.0%, p = 0.016). Hepatitis B carrier status, elevated baseline liver biochemical tests and the use of crude herbs (without processing) were associated with an increased risk of HILI-related mortality (adjusted hazard ratios [95% confidence intervals]: 2.90 [1.43-5.99], 2.40 [1.01-5.68] and 2.94 [1.45-5.97], respectively).

conclusionsHDS are popular and incriminated in more than one-fifth of drug-induced liver injuries in Taiwan. The patients with HILI were more severe than those with CILI in terms of liver biochemical tests, complications and mortality. Hepatitis B carriers, those with elevated baseline liver tests and crude herb users may have a higher risk of HILI-related mortality. The prudent use of HDS is suggested in these high-risk subjects.

Indexed as

Chemical and Drug Induced Liver InjuryChemical and Drug Induced Liver Injury, ChronicDietary SupplementsHumansProspective StudiesTaiwanAdverse drug reactionConventional drug-induced liver injuryDrug-induced liver injuryHepatitis BHepatotoxicityHerbal and dietary supplementsHerbal and dietary supplements-induced liver injuryLiver diseaseRisk factorToxicity

Identifiers

PMID34382132
OpenAlexW3188029460

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.