RUCAM in Drug and Herb Induced Liver Injury: The Update
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Open Access
- 24 December 2015
- journal article
- review article
- Published by MDPI AG in International Journal of Molecular Sciences
- Vol. 17 (1), 14
- https://doi.org/10.3390/ijms17010014
Abstract
RUCAM (Roussel Uclaf Causality Assessment Method) or its previous synonym CIOMS (Council for International Organizations of Medical Sciences) is a well established tool in common use to quantitatively assess causality in cases of suspected drug induced liver injury (DILI) and herb induced liver injury (HILI). Historical background and the original work confirm the use of RUCAM as single term for future cases, dismissing now the term CIOMS for reasons of simplicity and clarity. RUCAM represents a structured, standardized, validated, and hepatotoxicity specific diagnostic approach that attributes scores to individual key items, providing final quantitative gradings of causality for each suspect drug/herb in a case report. Experts from Europe and the United States had previously established in consensus meetings the first criteria of RUCAM to meet the requirements of clinicians and practitioners in care for their patients with suspected DILI and HILI. RUCAM was completed by additional criteria and validated, assisting to establish the timely diagnosis with a high degree of certainty. In many countries and for more than two decades, physicians, regulatory agencies, case report authors, and pharmaceutical companies successfully applied RUCAM for suspected DILI and HILI. Their practical experience, emerging new data on DILI and HILI characteristics, and few ambiguous questions in domains such alcohol use and exclusions of non-drug causes led to the present update of RUCAM. The aim was to reduce interobserver and intraobserver variability, to provide accurately defined, objective core elements, and to simplify the handling of the items. We now present the update of the well accepted original RUCAM scale and recommend its use for clinical, regulatory, publication, and expert purposes to validly establish causality in cases of suspected DILI and HILI, facilitating a straightforward application and an internationally harmonized approach of causality assessment as a common basic tool.Keywords
This publication has 155 references indexed in Scilit:
- Herbalife hepatotoxicity: Evaluation of cases with positive reexposure testsWorld Journal of Hepatology, 2013
- Drug-induced liver injury due to varenicline: a case reportBMC Gastroenterology, 2012
- Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum ThunbGut and Liver, 2011
- Acute Hepatitis E Infection Accounts for Some Cases of Suspected Drug-Induced Liver InjuryGastroenterology, 2011
- Susceptibility to Amoxicillin-Clavulanate-Induced Liver Injury Is Influenced by Multiple HLA Class I and II AllelesGastroenterology, 2011
- Paracetamol in therapeutic dosages and acute liver injury: causality assessment in a prospective case seriesBMC Gastroenterology, 2011
- Unrecognized acetaminophen toxicity as a cause of indeterminate acute liver failureJournal of Hepatology, 2010
- Aloe-induced Toxic HepatitisJournal of Korean Medical Science, 2010
- Causes, Clinical Features, and Outcomes From a Prospective Study of Drug-Induced Liver Injury in the United StatesGastroenterology, 2008
- Acute Drug-Induced Hepatitis Caused by AlbendazoleJournal of Korean Medical Science, 2008