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[Hepatitis due to nonsteroidal anti-inflammatory agents].
Y Furet1, E H Metman, M Breteau
1Service de Pharmacologie Clinique, CHR Bretonneau, Tours.
Annales De Gastroenterologie Et D'Hepatologie
|December 1, 1987
Summary
Non-steroidal anti-inflammatory drugs (NSAIDs) can cause rare but varied liver injuries. Monitoring liver enzymes is recommended for patients on long-term NSAID therapy due to potential hepatotoxicity.
Area of Science:
- Pharmacology
- Hepatology
- Toxicology
Background:
- Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed.
- Extended NSAID use is associated with various adverse effects, including uncommon hepatic injuries.
Purpose of the Study:
- To review the diverse hepatic injuries associated with different NSAID derivatives.
- To highlight the importance of monitoring liver function during long-term NSAID therapy.
Main Methods:
- Review of reported cases of NSAID-induced hepatotoxicity.
- Analysis of clinical presentation and evolution of liver injuries based on NSAID class.
Main Results:
- Salicylates can elevate transaminases; phenylbutazone is overtly hepatotoxic.
- Indole derivatives (indomethacin, sulindac) and propionic acid derivatives (ibuprofen, naproxen) show varied hepatotoxicity.
- Some NSAIDs (ibufenac, benoxaprofen) were withdrawn due to fatal outcomes; piroxicam and diclofenac also implicated.
Conclusions:
- NSAID-induced hepatotoxicity mechanisms are often drug-specific and not fully understood.
- Disease context and drug pharmacokinetics may influence liver injury.
- Regular monitoring of serum hepatic enzymes is advisable for patients on chronic NSAID treatment.