Related Experiment Video
Updated: Jul 5, 2025
11:06
Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro
Published on: January 31, 2022
4.4K
Drug-Induced Liver Injury in the Elderly: Consensus Statements and Recommendations from the IQ-DILI Initiative
Eric B Cohen1, Meenal Patwardhan2, Ritu Raheja2
1Pharmacovigilance and Patient Safety, AbbVie Inc., North Chicago, IL, USA. eric.cohen@abbvie.com.
Drug Safety
|January 13, 2024
Summary
Elderly patients face higher risks for drug-induced liver injury (DILI) due to multimorbidity and polypharmacy. More research is needed to improve DILI diagnosis, prognosis, and safety monitoring in this growing population.
Area of Science:
- Gerontology
- Hepatology
- Clinical Pharmacology
Background:
- The elderly population is rapidly expanding globally, presenting unique challenges in healthcare.
- Elderly patients are particularly vulnerable to adverse drug events, including serious drug-induced liver injury (DILI), due to factors like multimorbidity, polypharmacy, and frailty.
- Clinical trials have historically underrepresented older adults, leading to a knowledge gap regarding DILI in this demographic.
Purpose of the Study:
- To review existing literature on DILI in the elderly.
- To identify critical knowledge gaps and define the scope of "elderly" for DILI research.
- To highlight the need for improved data collection and inclusive practices in clinical trials, as recommended by regulatory agencies like the FDA and EMA.
Main Methods:
- Literature synthesis and review.
- Analysis of epidemiological factors contributing to DILI risk in older adults, such as polypharmacy and inappropriate prescribing.
- Examination of the biological impact of aging on liver function.
Main Results:
- While overall susceptibility to DILI may not be higher in the elderly, specific drugs may cause DILI more frequently in this population.
- A clear definition of "elderly" considering chronological age, biological age, and frailty is essential for accurate research.
- Understanding DILI in the elderly can enhance diagnostic and prognostic tools and improve liver safety monitoring.
Conclusions:
- Improved characterization of DILI in the elderly is a high-priority unmet need.
- Recommendations for optimized medical care and collaborative research are crucial for generating relevant data.
- Addressing DILI in older adults requires a concerted effort from clinicians, drug manufacturers, and regulatory scientists.
Related Concept Videos
01:21Factors Affecting Drug Response: Overview
2.0K
When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
2.0K
01:11Renal Failure: Dose Adjustments
92
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
92
01:13Therapeutic Index
4.3K
The therapeutic index of a drug is a key parameter in pharmacology that quantifies the relative safety of a drug by calculating the ratio between the dose that causes toxicity in half the population (50%) to the dose that proves to be effective for half the population (50%). It provides a spectrum of doses for a particular drug ranging from effective to potentially toxic. To illustrate, consider an anticoagulant agent like warfarin. It possesses a narrow window within its therapeutic index to...
4.3K
01:29Intellectual Disability
55
Intellectual disability (ID) is a neurodevelopmental condition characterized by deficits in intellectual and adaptive functioning that manifest during the developmental period. This condition encompasses challenges in reasoning, memory, problem-solving, and learning, accompanied by impairments in everyday life skills, such as communication, self-care, and social interactions. Intellectual disability affects approximately 1% of the population in the United States, impacting an estimated 5...
55