1. Angiotensin Receptor Blockers and the Risk of Suspected Drug-Induced Liver Injury: A Retrospective Cohort Study Using Electronic Health Record-Based Common Data Model in South Korea.
- Author
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Kim H, Son N, Jeong D, Yoo M, Choi IY, Choi W, Chung YW, Ko SW, Byun S, Im S, Sim DW, Seo J, Kang MG, Lee JK, Seo YG, An HJ, Kim Y, Chae S, Jun DW, Chang DJ, Kim SG, Yi S, Yang HJ, Lee I, Park HJ, Lee JH, Kim B, and Lee EE
- Subjects
- Humans, Republic of Korea epidemiology, Retrospective Studies, Male, Female, Middle Aged, Aged, Cohort Studies, Antihypertensive Agents adverse effects, Incidence, Adult, Valsartan adverse effects, Risk Factors, Benzimidazoles adverse effects, Chemical and Drug Induced Liver Injury epidemiology, Chemical and Drug Induced Liver Injury etiology, Angiotensin Receptor Antagonists adverse effects, Electronic Health Records statistics & numerical data
- Abstract
Introduction: Angiotensin receptor blockers are widely used antihypertensive drugs in South Korea. In 2021, the Korea Ministry of Food and Drug Safety acknowledged the need for national compensation for a drug-induced liver injury (DILI) after azilsartan use. However, little is known regarding the association between angiotensin receptor blockers and DILI., Objective: We conducted a retrospective cohort study in incident users of angiotensin receptor blockers from a common data model database (1 January, 2017-31 December, 2021) to compare the risk of DILI among specific angiotensin receptor blockers against valsartan., Methods: Patients were assigned to treatment groups at cohort entry based on prescribed angiotensin receptor blockers. Drug-induced liver injury was operationally defined using the International DILI Expert Working Group criteria. Cox regression analyses were conducted to derive hazard ratios and the inverse probability of treatment weighting method was applied. All analyses were performed using R., Results: In total, 229,881 angiotensin receptor blocker users from 20 university hospitals were included. Crude DILI incidence ranged from 15.6 to 82.8 per 1000 person-years in treatment groups, most were cholestatic and of mild severity. Overall, the risk of DILI was significantly lower in olmesartan users than in valsartan users (hazard ratio: 0.73 [95% confidence interval 0.55-0.96]). In monotherapy patients, the risk was significantly higher in azilsartan users than in valsartan users (hazard ratio: 6.55 [95% confidence interval 5.28-8.12])., Conclusions: We found a significantly higher risk of suspected DILI in patients receiving azilsartan monotherapy compared with valsartan monotherapy. Our findings emphasize the utility of real-world evidence in advancing our understanding of adverse drug reactions in clinical practice., (© 2024. The Author(s).)
- Published
- 2024
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