Meta-analysis of the incidence and risk factors of anti-tuberculosis drug-induced liver injury
- VernacularTitle:抗结核药物性肝损伤发生率及其危险因素的Meta分析
- Author:
Qinqin XIE
1
,
2
;
Huanhuan JI
2
;
Meiling GONG
1
,
2
;
Yuntao JIA
2
Author Information
1. School of Pharmacy，Chongqing Medical University，Chongqing 400016，China
2. Dept. of Pharmacy，Children’s Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/China International Science and Technology Cooperation Base of Child Development and Critical Disorders/Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity，Chongqing 400014，China
- Publication Type:Journal Article
- Keywords:
antitubercular agents;
drug-induced liver
- From:
China Pharmacy
2024;35(24):3052-3058
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the incidence of anti-tuberculosis drug-induced liver injury （ATB-DILI） and its risk factors. METHODS PubMed， Embase， the Cochrane Library， Web of Science， China Knowledge Network， VIP， Wanfang data and China Biomedical Literature Database were searched to collect cohort studies and case-control studies on the incidence and risk factors of ATB-DILI from the establishment of the database to 31 May 2024. After screening literature， extracting data and evaluating the quality of literature， meta-analysis was performed using Stata 17.0 and RevMan 5.3 software. RESULTS A total of 26 literature involving 38 971 patients were included， of which 4 106 patients suffered from ATB-DILI. Meta-analysis showed that the incidence of ATB-DILI was 12.94% [95%CI （10.82%，15.06%）， P＜0.001]； subgroup analysis showed that the incidence of ATB-DILI in cohort studies， Chinese studies and pediatric patients was higher （P＜0.001）. Age≥60 years， abnormal body mass index， alcoholism， smoking， history of liver disease， hepatitis B surface antigen positivity， extrapulmonary tuberculosis， malnutrition， hypoproteinemia， cardiovascular disease， diabetes mellitus， systemic lupus erythematosus， no prophylactic use of hepatoprotective drugs， and high baseline alanine transaminase levels were risk factors for developing ATB-DILI （P＜0.05）. Sensitivity analysis and publication bias analysis showed that the results obtained in this study were relatively robust. CONCLUSIONS The incidence of ATB-DILI in tuberculosis patients is 12.94%. Age≥60 years， abnormal body mass index， alcoholism， smoking， history of liver disease， hepatitis B surface antigen positivity， extrapulmonary tuberculosis， malnutrition， hypoproteinaemia， cardiovascular disease， diabetes mellitus， systemic lupus erythematosus， non-prophylactic use of hepatoprotective medications， and high baseline levels of alanine transaminase are the risk factors for developing ATB-DILI.
