Risk of liver injury after tigecycline therapy in China: real-world
evidence based on large samples
Abstract
Abstract: Minor hepatic impairment might already exist before meeting
the diagnostic criteria for tigecycline-induced liver injury. To clarify
the process, we performed a retrospective study among 1054 adult
inpatients treated with tigecycline to evaluate characteristics of each
indicator for liver function tests (LFTs) during the course. Indicators
of LFTs contained serum alanine aminotransferase (ALT), aspartate
aminotransferase (AST), alkaline phosphatase (ALP),
gamma-glutamyltransferase (GGT), and total bilirubin (TB). Incidence of
each indicator abnormality and dynamic changes of severity grading
during the course were evaluated respectively. Multiple logistic
analysis was applied to identify independent risk factors associated
with abnormal LFTs. 798 patients were finally included. Values of first
and peak abnormalities were significantly increased compared with those
at baseline. Gender was considered an independent factor for abnormal
ALT (OR=0.544, P=0.001), AST (OR=0.652, P=0.012) and GGT (OR=0.582,
P=0.006). High maintenance dosage (100mg twice daily) and prolonged
duration (>14 days) were independent risk factors for
abnormal ALT, AST, ALP, and GGT (P=0.000 for all parameters).
Furthermore, surgery (OR=1.513, P=0.005) and abnormal baseline LFTs
(OR=1.372, P=0.037) were independent risk factors for abnormal TB. The
current study first depicted characteristics of abnormal LFTs during
tigecycline therapy, facilitating early detection of liver injury.