Did This Drug Cause My Patient's Hepatitis?
Authors: Neil Kaplowitz, James H. Lewis, Paul B. Watkins
Journal: Annals of Internal Medicine (2003)

Letters21 January 2003Did This Drug Cause My Patient's Hepatitis?Neil Kaplowitz, MD, James H. Lewis, MD, and Paul B. Watkins, MDNeil Kaplowitz, MDUniversity of Southern California; Los Angeles, CA 90033 (Kaplowitz)Georgetown University Medical Center; Washington, DC 20007-2197 (Lewis)University of North Carolina; Chapel Hill, NC 27599-7600 (Watkins), James H. Lewis, MDUniversity of Southern California; Los Angeles, CA 90033 (Kaplowitz)Georgetown University Medical Center; Washington, DC 20007-2197 (Lewis)University of North Carolina; Chapel Hill, NC 27599-7600 (Watkins), and Paul B. Watkins, MDUniversity of Southern California; Los Angeles, CA 90033 (Kaplowitz)Georgetown University Medical Center; Washington, DC 20007-2197 (Lewis)University of North Carolina; Chapel Hill, NC 27599-7600 (Watkins)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-2-200301210-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Nierenberg (1) makes several important points about causality assessment in drug-induced liver disease and the role of postmarketing surveillance. The glitazones are used to illustrate the issues. With troglitazone, roughly 2 million patients were treated, nearly 1000 developed acute hepatitis, and nearly 100 developed acute liver failure resulting in liver transplantation or death (that is, a ratio of approximately 1 per 20 000). In contrast, more than 3 million patients have been treated with rosiglitazone and pioglitazone, and no more than a handful of cases of drug-induced hepatitis (2-7), including three cases of acute liver failure, ...References1. Nierenberg DW. Did this drug cause my patient's hepatitis? and related questions [Editorial]. Ann Intern Med. 2002;136:480-3. [PMID: 11900502] LinkGoogle Scholar2. Al-Salman J, Arjomand H, Kemp DG, Mittal M. Hepatocellular injury in a patient receiving rosiglitazone. A case report. Ann Intern Med. 2000;132:121-4. [PMID: 10644273] LinkGoogle Scholar3. Ravinuthala RS, Nori U. Rosiglitazone toxicity [Letter]. Ann Intern Med. 2000;133:658. [PMID: 11033603] LinkGoogle Scholar4. Chase MP, Yarze JC. Pioglitazone-associated fulminant hepatic failure [Letter]. Am J Gastroenterol. 2002;97:502-3. [PMID: 11866308] CrossrefMedlineGoogle Scholar5. Voorburg A, Erwaerman T, Frissen P, . Irreversible liver failure in a patient taking rosiglitazone. J Med. 2002;60:74. Google Scholar6. Forman LM, Simmons DA, Diamond RH. Hepatic failure in a patient taking rosiglitazone. Ann Intern Med. 2000;132:118-21. [PMID: 10644272] LinkGoogle Scholar7. May LD, Lefkowitch JH, Kram MT, Rubin DE. Mixed hepatocellular-cholestatic liver injury after pioglitazone therapy. Ann Intern Med. 2002;136:449-52. [PMID: 11900497] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Southern California; Los Angeles, CA 90033 (Kaplowitz)Georgetown University Medical Center; Washington, DC 20007-2197 (Lewis)University of North Carolina; Chapel Hill, NC 27599-7600 (Watkins)Disclosure: The authors are consultants to GlaxoSmithKline, the manufacturers of rosiglitazone. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHepatic Failure in a Patient Taking Rosiglitazone Lisa M. Forman , David A. Simmons , and Robert H. Diamond Hepatocellular Injury in a Patient Receiving Rosiglitazone: A Case Report Jameela Al-Salman , Heider Arjomand , David G. Kemp , and Manoj Mittal Rosiglitazone Toxicity Ravi Sudhir Ravinuthala and Uday Nori Mixed Hepatocellular–Cholestatic Liver Injury after Pioglitazone Therapy Louis D. May , Jay H. Lefkowitch , Michael T. Kram , and David E. Rubin "Did This Drug Cause My Patient's Hepatitis?" and Related Questions David W. Nierenberg Did This Drug Cause My Patient's Hepatitis? David W. Nierenberg Metrics Cited ByHepatic injury due to drugs, herbal compounds, chemicals and toxinsCase series of liver failure associated with rosiglitazone and pioglitazoneEvidence-based toxicology: call for papersTroglitazone and liver injury: In search of answers 21 January 2003Volume 138, Issue 2Page: 159KeywordsAcute liver failureDisclosureDrugsHepatitisHepatitis AHepatotoxinsHypersensitivityLiverLiver diseasesLiver transplantation ePublished: 21 January 2003 Issue Published: 21 January 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...