SynthesisBMC pharmacology & toxicology2025
Epidemiology of drug-related liver injury among the elderly: a systematic review and meta-analysis of incidence, and risk factors.
Synthesis in BMC pharmacology & toxicology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWith increasing global ageing and spreading trend of polypharmacy, it is crucial to systematically analyze the disease burden and risk factors of DILI in the elderly. The aim of this study was to systematically assess the incidence and risk factors of drug-induced liver injury (DILI) in the elderly.
methodsPubMed, Embase and Web of Science databases from 1 January 2000 to 24 March 2025 were systematically searched. Two independent reviewers selected studies, extracted data and assessed risk of bias. The quality of included studies was assessed using the Newcastle-Ottawa scale. Meta-analyses were conducted to quantify the incidence and risk factors of DILI in elderly.
resultsA total of 16 studies including 8,847 elderly patients with DILI were included. Overall, the incidence of DILI in the elderly population was 25% (95% CI: 18%-31%). In addition, risk factors for DILI in older adults included being female (OR = 1.35, 95% CI: 1.12–1.63; P = 0.003), alcohol use (OR = 2.10, 95% CI: 1.50–2.94; P < 0.001), diabetes mellitus (OR = 1.30. 95% CI: 1.10–1.54; P = 0.008), chronic liver disease (OR = 3.25, 95% CI: 2.20–4.80; P < 0.001), malignancy (OR = 1.80, 95% CI: 1.20–2.70; P = 0.004), antimicrobials (OR = 2.50, 95% CI: 1.90–3.30; P < 0.001), immunosuppressants (OR = 2.20, 95% CI: 1.60-3.00; P < 0.001), and antineoplastics (OR = 3.00, 95% CI: 2.10–4.30; P < 0.001), non-steroidal anti-inflammatory drugs (OR = 1.70, 95% CI: 1.25–2.30; P < 0.001), and antiviral drugs (OR = 1.90, 95% CI: 1.30–2.80; P < 0.001).
conclusionThis study systematically quantified the prevalence and risk factors of DILI in the elderly population, highlighting the high risk of chronic liver disease, antineoplastic drugs and antimicrobials.
trial registrationNot applicable.
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