Sacubitril/valsartan-induced liver injury: A case report and literature review.
Study Goal
The researchers aimed to evaluate the use of polyene phosphatidylcholine as part of liver protection therapy in a case of drug-induced liver injury caused by sacubitril/valsartan.
Results Summary
Polyene phosphatidylcholine was administered alongside magnesium isoglycyrrhizinate to support liver function recovery after sacubitril/valsartan-induced injury. The patient's liver function improved following the intervention and discontinuation of the offending drug.
Population
A 90-year-old female with chronic heart failure and drug-induced liver injury.
Effective Dosage
456 mg, 3 times daily.
Duration
Not specified.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
sacubitril/valsartan | increase | severe liver injury | 90-year-old female patient | - | caused | #1 |
sacubitril/valsartan | increase | hepatic transaminases | 90-year-old female patient | - | increased | #2 |
magnesium isoglycyrrhizinate | increase | hepatic function | 90-year-old female patient | 100 mg daily | general liver protection methods to improve | #3 |
polyene phosphatidylcholine capsules | increase | hepatic function | 90-year-old female patient | 456 mg 3 times daily | general liver protection methods to improve | #4 |
sacubitril/valsartan withdrawal | increase | liver function | 90-year-old female patient | - | gradually returned to normal | #5 |
RATIONALE: Sacubitril/valsartan (Entresto) is the first drug approved for the treatment of symptomatic chronic heart failure with reduced ejection fraction in adult patients. There have been no reports of hepatotoxicity secondary to sacubitril/valsartan administration. Here, we report the first case of severe liver injury caused by sacubitril/valsartan. PATIENT CONCERNS: A 90-year-old female patient taking sacubitril/valsartan was admitted due to chronic heart failure. Subsequently, the patient developed serious liver injury with increased hepatic transaminases. DIAGNOSIS: Drug-induced liver injury, sacubitril/valsartan-related. No liver injury caused by other reasons was observed after thorough examination. After the withdrawal of sacubitril/valsartan, the liver function of the patient gradually returned to normal. INTERVENTIONS: We chose general liver protection methods to improve her hepatic function, including magnesium isoglycyrrhizinate at 100 mg daily and polyene phosphatidylcholine capsules at 456 mg 3 times daily. We consulted with a hepatologist to discuss the best plan for her treatment. The last, we stopped sacubitril/valsartan. OUTCOMES: After the withdrawal of sacubitril/valsartan, the liver function of the patient gradually returned to normal. LESSONS: Sacubitril/valsartan-induced liver injury is very rare. Clinicians should pay particular attention to the possibility of hepatotoxicity during sacubitril/valsartan treatment.