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Review
. 2020 Sep 29;7(10):62.
doi: 10.3390/medicines7100062.

Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993-Mid 2020: A Comprehensive Analysis

Rolf Teschke  1 , Gaby Danan  2
Affiliations
Review

Worldwide Use of RUCAM for Causality Assessment in 81,856 Idiosyncratic DILI and 14,029 HILI Cases Published 1993-Mid 2020: A Comprehensive Analysis

Rolf Teschke et al. Medicines (Basel). .

Abstract

Background: A large number of idiosyncratic drug induced liver injury (iDILI) and herb induced liver injury(HILI) cases of variable quality has been published but some are a matter of concern if the cases were not evaluated for causality using a robust causality assessment method (CAM) such as RUCAM (Roussel Uclaf Causality Assessment Method) as diagnostiinjuryc algorithm. The purpose of this analysis was to evaluate the worldwide use of RUCAM in iDILI and HILI cases. Methods: The PubMed database (1993-30 June 2020) was searched for articles by using the following key terms: Roussel Uclaf Causality Assessment Method; RUCAM; Idiosyncratic drug induced liver injury; iDILI; Herb induced liver injury; HILI. Results: Considering reports published worldwide since 1993, our analysis showed the use of RUCAM for causality assessment in 95,885 cases of liver injury including 81,856 cases of idiosyncratic DILI and 14,029 cases of HILI. Among the top countries providing RUCAM based DILI cases were, in decreasing order, China, the US, Germany, Korea, and Italy, with China, Korea, Germany, India, and the US as the top countries for HILI. Conclusion: Since 1993 RUCAM is certainly the most widely used method to assess causality in IDILI and HILI. This should encourage practitioner, experts, and regulatory agencies to use it in order to reinforce their diagnosis and to take sound decisions.

Keywords: DILI; HILI; RUCAM; Roussel Uclaf Causality Assessment Method; diagnostic algorithm; herb induced liver injury; iDILI; iDrug induced liver injury.

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Conflict of interest statement

The authors declared that they have no conflict of interests regarding this invited article.

Figures

Figure 1
Figure 1
Annual cases of DILI assessed for causality by RUCAM and published since 1993.
Figure 2
Figure 2
Annual publications of DILI cases assessed for causality by RUCAM as reported since 1993.
Figure 3
Figure 3
Annual cases of HILI cases assessed for causality by RUCAM and published since 1993.
Figure 4
Figure 4
Annual publications of HILI cases assessed for causality by RUCAM as reported since 1993.
See this image and copyright information in PMC

References

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