Evaluation of the efficacy of a hepatoprotector for the treatment of toxic (drug-induced) liver injury

Introduction. Toxic liver injury is widespread among patients, especially those with comorbidities and polypharmacy. The non-specific clinical manifestations and significant variability in liver and systemic changes complicate timely diagnosis and initiation of treatment. Aim. To evaluate the effectiveness of therapy for toxic (drug-induced) liver injury using a hepatoprotective agent containing inosine, meglumine, methionine, nicotinamide and succinic acid. Materials and methods. A total of 178 patients (152 men, 26 women) with confirmed drug-induced liver injury were examined. The main group (n = 104) received hepatoprotective agent containing inosine, meglumine, methionine, nicotinamide and succinic acid intravenously (400–800 ml, up to 14 days) in addition to standard therapy. The control group received conventional detoxification and symptomatic treatment. Clinical and laboratory evaluation was performed, including assessment of liver function biochemical markers. Results. By day 21, the main group showed a statistically significant improvement: ALT decreased from 531 ± 112 to 46 ± 25 U/L, AST from 587 ± 126 to 41 ± 35 U/L, ALP from 378 ± 76 to 86 ± 44 U/L, GGT from 418 ± 92 to 58 ± 24 U/L; albumin increased from 29 ± 4 to 41 ± 3 g/L, and the prothrombin index from 54 ± 12 to 94 ± 6% (p < 0.001). Improvements in the control group were less pronounced. Conclusion. Hepatoprotective agent containing inosine, meglumine, methionine, nicotinamide and succinic acid demonstrated efficacy by reducing several adverse clinical manifestations of toxic (drug-induced) liver injury, including resolution of cytolysis and cholestasis syndromes, restoration of protein-synthetic liver function, and improvement of hematological parameters.