AB1024 Risk of drug induced liver injury from nsaids in patients with gout

Background Drug Induced Liver Injury (DILI) in patients under nonsteroidal anti-inflammatory drugs (NSAIDs) is more frequently presented by hepatocellular damage when serum alanine aminotransferase (ALT) level exceeds 2 times (or more) the upper limits of norms.1 The value of minimal hypertransaminasemia (MHTE) (when serum ALT exceeds the upper limit of normal up to twice) is still not clear today. Objectives To define the terms of DILI development and the value of MHTE in patients with gouty arthritis (GA) under NSAIDs. Methods 189 patients (25,6%) of 738 with GAACR, 1977 were included in our retrospective study. At the onset of gout attack, all patients had normal basal serum ALT, which elevated after starting NSAIDs therapy. Pre-existing liver impairment was not registered. Patients were divided into 2 groups according to the changes in serum ALT after NSAIDs treatment: patients with MHTE (n=101) and those with DILI (n=88). The mean age of 5549–60 years and 5444–59,5 years as well as the sex distribution (men 90,1% and 93,3%, respectively) were compatible in both the groups (p Results The mean duration of NSAIDs therapy in the groups made 85–10 days in MHTE group and 106–14 days in DILI group. Statistically significant difference (U=3236, p Conclusions 25,6% of patients with GA have demonstrated elevated serum ALT after NSAIDs therapy: MHTE developed in 13,7% of cases, DILI in 11,9%. Our study showed that MHTE developed in the period less than 11 days of high dose NSAIDs treatment with DILI being likely to occur during more prolonged treatment. MHTE group may be considered as a risk group for DILI development. Reference [1] Aithal G. P. Hepatotoxicity related to antirheumatic drugs. Nat. Rev. Rheumatol. 2011; 7: 139–150. Disclosure of Interest None declared