Chinese Journal of Pharmacovigilance ›› 2025, Vol. 22 ›› Issue (4): 410-414.
DOI: 10.19803/j.1672-8629.20240870

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Clinical Features and Risk Factors of Liver Injury Induced by Atypical Antipsychotic Drugs

CHEN Huan1,2,3,4, LIANG Jun1,2,3,4, ZHAO Wei1,2,3,4, XIA Qingrong1,2,3,4,*   

  1. 1Department of Pharmacy, Affiliated Psychological Hospital of Anhui Medical University, Hefei Anhui 230022, China;
    2Department of Pharmacy, Hefei Fourth People’s Hospital, Hefei Anhui 230022, China;
    3Department of Mental Pharmacology, Anhui Mental Health Center, Hefei Anhui 230022, China;
    4Clinical Medical Research Center of Mental and Psychological Diseases in Anhui Province, Hefei Anhui 230022, China
  • Received:2024-11-08 Published:2025-04-17

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Abstract: Objective To investigate the clinical characteristics and risk factors of drug-induced liver injury (DILI) induced by atypical antipsychotic drugs (AAPs) in our hospital in order to provide a reference for safe drug use. Methods The medical records of 122 patients who had received AAPs treatment for DILI at Hefei Fourth People’s Hospital between 2020 to and 2023 were retrospectively analyzed, including gender, age, disease history, medication history, blood routine, blood glucose, liver and kidney function, initial medication and indexes of combined medications. The control group was randomly matched at a ratio of 1∶1, and the risk factors for liver injury were studied logistic regression analysis. Based on the results of analysis, the receiver operating curve (ROC) was drawn to analyze the ability of risk factors to predict DILI. Results Among the 122 patients with AAPs induced DILI, the male to female ratio was 1∶1.22, and the average age was (32.98 ± 14.04) years. Olanzapine caused the largest number of cases of DILI during treatment (52 cases, 42.62%), and the proportion of hepatocyte injury in the clinical classification of DILI was the highest (87 cases, 71.31%). The degree of liver injury was mostly mild (121 cases, 99.18%), and most of the patients improved after symptomatic treatment (62 cases, 50.82%) or liver function returned to normal (43 cases, 35.25%). Logistic regression analysis showed that total bilirubin (TBIL), drug dose, fatty liver and combination of drugs were risk factors for liver injury caused by AAPs (P<0.05). The AUC value of the ROC curve for the combined application of the above risk factors was 0.809, with a sensitivity of 75.40% and a specificity of 76.00%, suggesting good predictability. Conclusion DILI caused by APPs occurs mostly in adult patients, and olanzapine is the biggest contributor. The clinical manifestations are primarily hepatocyte damage. Total bilirubin, drug dose, fatty liver and drug combination are important risk factors. The risk assessment of drug use should be assessed, liver function closely monitored, and adverse drug reactions reduced.

Key words: Atypical Antipsychotic Drugs, Olanzapine, Drug-Induced Liver Injury, Retrospective Analysis, Clinical Characteristics, Risk Factors, Clinical Outcome

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