title: Drug-induced liver injury in the elderly.
abstract: Historically, the elderly have been considered to be at increased risk for drug-induced liver injury (DILI). Animal studies have demonstrated changes in hepatic physiology that affect drug metabolism in the aging liver; however, there is no evidence that this leads to any appreciable deterioration of liver function in healthy older humans. Updated data from international DILI registries give us pause to consider whether the elderly are truly at increased risk to develop hepatic injury. Instead, hepatotoxicity in the elderly appears to be more a function of drug exposure, polypharmacy and drug-drug interactions. Isoniazid and benoxaprofen are the only two agents with a well-studied correlation between increasing age and risk of DILI. Nevertheless, given the increasing proportion of patients over age 65 in the U.S. and abroad, the influence of age on the risk of DILI is the focus of this review.
authors.affiliation: Division of Gastroenterology, Hepatology Section, Department of Internal Medicine, Georgetown University Hospital, Washington, DC 20007, USA. jonathan.stine@gmail.com
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Stine
authors.forename: Praveen
authors.initials: P
authors.lastname: Sateesh
authors.forename: James H
authors.initials: JH
authors.lastname: Lewis
mesh_terms: D000367:Age Factors; D000368:Aged; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D004347:Drug Interactions; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects; D008297:Male; D019338:Polypharmacy; D012307:Risk Factors; D012737:Sex Factors