( Once a drug has been associated with ...)UNC launches study of liver injury caused by drugs

"Once a drug has been associated with severe liver injury, physicians are understandably hesitant to prescribe it, even if it may provide the best benefit for that patient," said Dr. Mark Russo, assistant professor of medicine and DILIN investigator at UNC.

One goal of the network is to develop testing that will identify patients who are at risk and, therefore, should not receive treatment with certain drugs.

Patients diagnosed with potentially severe liver injury due to any medication are eligible if enrolled within six months of the event. These people will be followed over time to find out what happens as a result of their injury. People who have not sustained liver injury but who have taken any of the medications in question also will be enrolled for comparison.

In addition to enrolling patients as they are brought to medical attention, DILIN is establishing a registry of patients who at any time since 1994 developed severe liver injury due to one of four specific drugs. The four are the tuberculosis drug isoniazid, the anti-seizure medications phenytoin and valproic acid, and the antibiotic amoxicillin-clavulanate potassium.

"Eligible patients from anywhere in North Carolina or neighboring states who are willing to come to UNC can be enrolled now," Watkins said. "Overall, we believe that the network will bring greater focus and interest to the study of drug-induced liver injury and will help to develop better ways to prevent, detect and treat this growing problem," Watkins said.

DILIN also may provide important insight into medical problems beyond liver injury induced by drugs, he added.

"Drug-induced liver injury is an ideal model to study how genes and environment interact to produce disease in some but not all people. We hope the factors identified by DILIN research will provide clues to susceptibility to the many diseases that represent an interaction with the environment."