Evaluation of hepatotoxicity in patients exposed to neuromodulator and antineoplastic drugs

OBJECTIVE: Hepatotoxicity is damage to the liver caused by various possible agents. The term DILI (Drug Induced Liver Injury) is utilized when a drug is identified as the cause. The aim of this study was to evaluate DILI in patients who have used neuromodulators and antineoplastic medications at a university hospital. MATERIALS AND METHODS: A cross-sectional retrospective study was performed on adult patients (>18 years). The hepatotoxicity induced by neuromodulator drugs (carbamazepine, duloxetine and gabapentin) administered during the hospital stay and by antineoplastic drugs (capecitabine, cisplatin, oxaliplatin, 5-fluorouracil and sorafenib) utilized in hospital or during out-patient care at Hospital de Clínicas de Porto Alegre, was analyzed during the period from January 2019 to January 2020, before the COVID-19 pandemic.  The data were collected through medical histories and recorded to analyze the epidemiological, clinical and outcome variables. RESULTS: 1,261 patients used neuromodulating drugs at that hospital, and of these, 105 presented altered liver function tests, 0.24% (n=3) due to DILI. Of the patients using antineoplastic drugs (n=245), 43 patients presented altered liver function tests, 2.0% (n=5) caused by DILI. CONCLUSIONS: A low frequency of DILI was obtained in patients who utilized neuromodulators and antineoplastic drugs, which may mean a safe profile for using these drugs, showing less toxicity over time. A tendency for a greater incidence of DILI was observed in antineoplastic drugs compared to the neuromodulators, which is to be expected since the profile of a patient who is undergoing treatment for cancer is more compromised.

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