Development of an Australian Drug-Induced Liver Injury Network

Background and Aim: Drug-induced liver injury (DILI) can involve serious adverse reactions to many drug classes, causing a wide clinical and biochemical spectrum of liver injury. Despite a rise in prevalence and it being the most common cause of acute liver failure in the Western world, it is often unrecognized. There are limited recent data on the common causes of DILI in Australia. Fourteen liver units in Australia agreed to collaborate. We present here the interim results from the first center. Methods: A prospective clinical audit was done of patients with reported DILI between June 2018 and April 2021, inclusive. Results: The interim results for the first 93 patients are shown in Table 1. Only seven patients (7.5%) had underlying liver disease. Thirty patients (32%) had some form of treatment, although 12 (13%) were already using corticosteroids for pre-existing illnesses. The liver injury became chronic (lasted >6 months) in 10% of cases. Five of 17 patients (29%) prescribed remdesivir for coronavirus disease 2019 developed DILI, despite four (80%) concurrently receiving dexamethasone. Conclusion: DILI remains a significant cause of morbidity and mortality, with new agents like remdesivir and old agents like antibiotics comprising the main causes.