Drug Induced Liver Injury: Is there an Indication for Ursodeoxycholic Acid Use?

Abstract

Drug induced liver injury (DILI) is one of the most conflicting diagnoses for hepatologists. DILI is defined as an acute or chronic liver injury, manifested by alteration of liver function tests, due to the consumption of medications, herbal or dietary supplements, after excluding other etiologies of liver disease. Several facts contribute to DILI; among them, host related factors, as age, sex, alcohol consumption and underlying chronic diseases; and drug related, as dose, lipophilicity, drug metabolism and interactions. Few treatments for DILI are actually recommended in current guidelines. Ursodeoxycholic acid (UDCA) use for DILI is debated, because of the lack of clinical trials proving its efficacy. Hence, in several case reports UDCA has been used for DILI with good results preventing the progression of the disease and the need of liver transplantation. Small series have also described the resolution or amelioration of DILI with the use of UDCA. Nonetheless, current guidelines do not support its wide use. The aim of this review is to discuss the current knowledge of DILI and the mechanisms of action and facts of the use of UDCA in DILI, making UDCA a promising alternative for the treatment of DILI. Keywords: Drug-induced liver injury, Ursodeoxycholic acid, biliary transporters, vanishing bile duct syndrome, cholestasis. Read more →