Trends in drug-induced liver injury (DILI): a case report-based analysis of clinical presentation, severity, preventability, seriousness, and outcomes over the last decade

BACKGROUND: DILI causes about 50 % of acute liver failures globally, affecting 14-19 per 100,000 annually, and is a leading cause of liver failure and drug withdrawals in the USA and Europe. METHODS: This study reviewed 60 case reports of drug-induced liver injury from Medline/PubMed (2015-2025) at Kalpana Chawla Government Medical College. Initially, 108 reports were identified using specific criteria, screened independently by two teams, with duplicates and ineligible reports removed for analysis. RESULTS: This analysis of 60 drug-induced liver injury case reports from PubMed/Medline in past decade found that patients averaged 54.6 years old, with 55 % female. Most cases occurred in the USA, China, and Japan. Jaundice (42 %) and fatigue (34 %) were common symptoms. Hepatocellular injury was most prevalent (45 %). Atorvastatin and Methimazole were frequently implicated drugs, with 75 % involving polypharmacy. Most ADRs occurred within 2.3 months of treatment initiation. Drug withdrawal was the primary intervention (93 %), resulting in full recovery in 87 % of cases, though 3 % were fatal. CONCLUSIONS: Analysis of 60 DILI cases identified risk factors such as age over 55, female sex, high doses, and polypharmacy. Most cases were drug-related; 78 % required hospitalization. Prevention could reduce cases by up to 50 %, with full recovery upon drug withdrawal.