Evidence map›Paper›PMID 42020558›Full record

ArticleEuropean journal of clinical pharmacology2026

Association of high risk of liver fibrosis in patients with serious outcomes of adverse drug reactions.

Joana Henze, Harald Dormann, Carolin V Schneider, Corinna Meeßen, Anja Knüppel-Ruppert, Andrea Kriegisch-Stumpf, Matthias Schwab, Julia C Stingl, Katja S Just

Abstract readMulticenter Study
In one paragraph

Article in European journal of clinical pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Refining FIB-4-based risk stratification in adverse drug reactions.European journal of clinical pharmacology · 2026
    Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Joana HenzeInstitute of Clinical Pharmacology, University Hospital RWTH Aachen, Wendlingweg 2, Aachen, D-52074, Germany.
Harald DormannEmergency Department, Klinikum Fürth, Fürth, Germany.
Carolin V SchneiderDepartment of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.
Corinna MeeßenDepartment of Medicine III, University Hospital RWTH Aachen, Aachen, Germany.
Anja Knüppel-RuppertEmergency Department, Klinikum Fürth, Fürth, Germany.
Andrea Kriegisch-StumpfCentral Emergency Department, Hospital Ingolstadt, Ingolstadt, Germany.
Matthias SchwabDr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.
Julia C StinglDepartment of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany.
Katja S JustInstitute of Clinical Pharmacology, University Hospital RWTH Aachen, Wendlingweg 2, Aachen, D-52074, Germany. kjust@ukaachen.de.ORCID http://orcid.org/0000-0002-6782-8078

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMetabolic dysfunction–associated steatotic liver disease (MASLD) as the main cause of chronic liver disease worldwide is associated with increased mortality. Especially in patients with fibrosis, an increased risk of adverse drug reactions (ADRs) might be present. Therefore, the impact of high-risk for liver fibrosis on the outcome of ADRs was analyzed.

methodsPatients of a multicenter cohort study in maximum care emergency departments (ED) with admissions due to ADRs with available FIB-4 score parameters were analyzed. The cohort was divided into patients with low (FIB-4 < 2.67) and high (FIB-4 ≥ 2.67) liver fibrosis risk. Triage at ED admission, ADR seriousness criteria, discharge status, and length of hospital stay were used as outcomes. Logistic and linear regression analyses were applied.

resultsAmong the 1087 patients, 407 had a high risk of fibrosis (37.4%). High risk of fibrosis was associated with serious ADRs (OR 2.42 (95% CI 1.57–3.73)), a poor discharge status including deaths (3.51 (2.20–5.60)), and a longer stay in the hospital (2.02 (1.00–3.05)), while urgent triage at ED admission was not significantly associated with high fibrosis risk (0.95 (0.71–1.28)).

conclusionIn patients at risk of MASLD, careful risk assessment is essential when prescribing drugs, as serious ADRs may occur unnoticed in the presence of liver fibrosis. Even simple non-invasive tests like the FIB-4 score may provide valuable prognostic hints in the acute event of an ADR.

Indexed as

Drug-Related Side Effects and Adverse ReactionsLiver CirrhosisAdultAgedCohort StudiesEmergency Service, HospitalFemaleHumansLength of StayMaleMiddle AgedRisk FactorsAdverse drug reactionDrug treatmentLiver fibrosisMetabolic dysfunction–associated steatotic liver disease

Identifiers

PMID42020558
PMCPMC13102728

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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.