Evidence map›Paper›PMID 34727797›Full record

SynthesisExpert opinion on drug metabolism & toxicology2021

Biomarkers of idiosyncratic drug-induced liver injury (DILI) - a systematic review.

Edmond Atallah, Cristiana Freixo, Ismael Alvarez-Alvarez, F J Cubero, Alexander L Gerbes, Gerd A Kullak-Ublick, Guruprasad P Aithal

Open access · bronzeAbstract readSystematic Review
In one paragraph

Synthesis in Expert opinion on drug metabolism & toxicology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed
2.3field-weighted citation impact, top 13% 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

14 citing papers in PubMed, 20 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Article
  6. Drug-Induced Liver Injury-Pharmacological Spectrum Among Children.International journal of molecular sciences · 2025
    Review
  7. Drug-Induced Liver Injury Associated With Emerging Cancer Therapies.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Review
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Review
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

7 authors at 6 institutions in 5 countries.

Edmond AtallahSchool of Medicine, Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK.ORCID 0000-0002-7341-9174
Cristiana FreixoCintesis, Center for Health Technology and Services Research, Faculdade De Medicina Da Universidade Do Porto, Porto, Portugal.
Ismael Alvarez-AlvarezServicio De Farmacología Clínica and Ugc Aparato Digestivo, Hospital Universitario Virgen De La Victoria, Instituto De Investigación Biomédica De Málaga-IBIMA, Universidad De Málaga, Málaga, Spain.ORCID 0000-0001-6271-0604
F J CuberoCentro De Investigación Biomédica En Red De Enfermedades Hepáticas Y Digestivas (Ciberehd), Madrid, Spain.ORCID 0000-0003-1499-650X
Alexander L GerbesDepartment of Medicine, Liver Centre Munich, University Hospital Munich, Munich, Germany.
Gerd A Kullak-UblickDepartment of Clinical Pharmacology and Toxicology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.ORCID 0000-0002-0757-4408
Guruprasad P AithalSchool of Medicine, Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK.ORCID 0000-0003-3924-4830
University of Nottingham · GBCentre for Health Technology and Services Research · PTCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ESLMU Klinikum · DENovartis (Switzerland) · CHUniversidad Complutense de Madrid · ES

Funding

Department of Health IS-BRU-0211-20106
6 · The paper itself

Abstract

introductionIdiosyncratic drug-induced liver injury (DILI) is an unpredictable event, and there are no specific biomarkers that can distinguish DILI from alternative explanations or predict its clinical outcomes. AREAS COVERED: This systematic review summarizes the available evidence for all biomarkers proposed to have a role in the diagnosis or prognosis of DILI. Following a comprehensive search, we included all types of studies in humans. We included DILI cases based on any threshold criteria but excluded intrinsic DILI, commonly caused by paracetamol overdose. We classified studies into diagnostic and prognostic categories and assessed their methodological quality. After reviewing the literature, 14 studies were eligible. EXPERT OPINION: Diagnostic studies were heterogeneous with regard to the study population and outcomes measured. Prognostic models were developed by integrating novel biomarkers, risk scores, and traditional biomarkers, which increased their prognostic ability to predict death or transplantation by 6 months. This systematic review highlights the case of need for non-genetic biomarkers that distinguish DILI from acute liver injury related to alternative etiology. Biomarkers with the potential to identify serious adverse outcomes from acute DILI should be validated in independent prospective cohorts with a substantial number of cases.

Indexed as

Chemical and Drug Induced Liver InjuryDrug-Related Side Effects and Adverse ReactionsBiomarkersHumansLiverProspective StudiesRisk FactorsBiomarkersbiomarkersDILIDrug-induced liver injuryhepatotoxicitysystematic review

Identifiers

PMID34727797
PMCPMC7617394
OpenAlexW3208598104

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.