Literature case analysis of thalidomide and its analogs-associated liver injury
10.3760/cma.j.cn114015-20220927-00877
- VernacularTitle:沙利度胺及其类似物相关肝损伤文献病例分析
- Author:
Yu LIANG
1
;
Jun ZHAO
;
Beibei NI
;
Xiao LI
;
Qie GUO
;
Zhen MENG
Author Information
1. 青岛大学附属医院药学部，青岛 266003
- Publication Type:Journal Article
- Keywords:
Chemical and drug induced liver injure;
Thalidomide;
Lenalidomide;
Pomalidomide
- From:
Adverse Drug Reactions Journal
2023;25(2):89-94
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To know the clinical characteristics of liver injury related to thalidomide and its analogs.Methods:The relevant databases at home and abroad (up to August 31, 2022) were searched and the case reports on thalidomide and its analogs-associated liver injury were collected. The patients′ gender, age, primary disease, drug use, occurrence of liver injury (onset time, clinical manifestations, liver function status, liver injury classification, etc.), treatment and outcome were recorded and descriptively analyzed.Results:A total of 18 patients were enrolled, including 11 males and 7 females, aged from 36 to 93 years with an average age of 60 years. The primary disease was multiple myeloma in 16 patients, plasma cell leukemia and myelodysplastic syndrome in 1 patient each. Thalidomide was used in 9 patients, lenalidomide in 6 patients and pomalidomide in 3 patients. The time from the beginning of medication to the occurrence of liver injury ranged from 4 to 232 days and it was ≤ 60 days in 15 patients. The classification of liver injury was hepatocellular type in 9 patients, cholestasis type in 7 patients, and unable to be determined due to lack of data in 2 patients. Different degrees of abnormal liver function appeared in 18 patients, mainly including elevated alanine aminotransferase and aspartate aminotransferase (in 16 patients), elevated total bilirubin (in 14 patients), and elevated alkaline phosphatase (in 12 patients). Clinical symptoms were recorded in 15 patients, including jaundice (in 13 cases), fatigue (in 7 cases) and nausea (in 4 cases). After diagnosis of liver injury, thalidomide or its analogues were discontinued in all 18 patients, and 4 cases received symptomatic and supportive therapy. Liver function in 13 patients was improved or returned to normal within 7 to 28 days after drug withdrawal, and 5 patients died (2 cases died of liver failure, 3 cases died of primary diseases or other complications).Conclusions:Thalidomide and its analogs associated liver injury mostly occurs within 2 months after drug administration and the clinical symptoms were similar to those caused by other drugs. After drug withdrawal, the liver function in most patients could be improved or return to normal, but a few may progress to liver failure and death.
