Drug-induced liver injury associated with liraglutide use: a systematic review of detection, severity, causality assessment, and clinical outcomes

Faisal Inayat^{1 *}, Ahmad Azeem Khan¹, Arslan Afzal², Sobaan Taj³, Muhammad Kashif Amin⁴, Attiq Ur Rehman⁵, Muhammad Hassan Naeem Goraya¹, Gul Nawaz¹, Rizwan Ishtiaq⁶, Ali Jaan⁴, Izzah Vasim⁷

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¹ Department of Internal Medicine, Allama Iqbal Medical College, Lahore, Punjab, Pakistan

² Department of Internal Medicine, Woodhull Medical Center, Brooklyn, New York, United States of America

³ Department of Internal Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, United States of America

⁴ Department of Internal Medicine, King Edward Medical University, Lahore, Punjab, Pakistan

⁵ Department of Hepatology, Mercy Medical Center, Baltimore, Maryland, United States of America

⁶ Department of Internal Medicine, Saint Francis Hospital and Medical Center, Hartford, Connecticut, United States of America

⁷ Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America

JCTR 2023, 9(3), 168–174; https://doi.org/10.18053/jctres.09.202303.004

Submitted: 22 December 2022 | Revised: 2 April 2023 | Accepted: 3 April 2023 | Published: 12 May 2023

© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )

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Abstract

Background and aim: Drug-induced liver injury (DILI) remains the most important etiology of acute liver failure in the United States. It often presents a diagnostic conundrum due to the lack of a specific biomarker or diagnostic modality. Liraglutide, a glucagon-like peptide-1 agonist, has recently gained clinical importance for its anti-obesity and anti-diabetic effects. While a constellation of adverse events has been reported, the published data on the safety profile remains limited. We hereby delineate a rare case of liraglutide-associated DILI. Furthermore, a systematic review of MEDLINE, Google Scholar, Scopus, and Cochrane databases was conducted on DILI following liraglutide therapy. Specific terminologies were used to identify relevant English-language articles. The latest search date was December 20, 2022. Our search identified a total of 4 case reports (level of clinical evidence: IV). We discuss the limited available data on detection, severity, causality assessment, and clinical outcomes in patients with liraglutide-induced DILI.

Relevance for Patients: DILI can rarely occur in patients undergoing liraglutide therapy. Clinicians and hepatologists can play a vital role by promptly recognizing and stopping the offending agent. Therefore, intensive pharmacovigilance is imperative for ensuring the safety of patients. Patients on liraglutide may be considered for baseline testing and periodic liver function monitoring, particularly if they have pre-existing risk factors for DILI.

Keywords

Drug-induced liver injury

Glucagon-like peptide-1 agonist

Hepatotoxicity

Liraglutide

Pharmacovigilance

Conflict of interest

The authors disclose no conflicts of interest.

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