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Purpose of review <p>To evaluate the critical role of international registries in understanding idiosyncratic drug-induced liver injury (DILI) by comparing clinical and epidemiological data from the Spanish DILI Registry, the Pro-Euro DILI registry, and the US DILIN.</p> Recent findings <p>Although amoxicillin-clavulanic acid remains the leading global DILI trigger, DILI cases in the US show higher severity and more herbal supplement involvement. Immune checkpoint inhibitors present new toxicity phenotypes. Registry collaborations have yielded advanced prognostic tools like the nR criteria for predicting liver failure, and RECAM, a novel electronic causality assessment scale offering greater diagnostic precision than RUCAM.</p> Summary <p>Registries are crucial for identifying rare DILI events that are missed by clinical trials, as well as for highlighting regional differences in triggers and outcomes. These networks are essential for identifying diagnostic biomarkers, and their findings benefit not only clinicians, but also regulators. Future research should prioritize the global validation of RECAM and utilize multinational biobanks to identify genetic risk factors, ultimately improving drug safety.</p>

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DILI Differences and Similarities between the US and Europe

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月11日

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  • Juan Pedro Toro-Ortiz,
  • Raúl J. Andrade,
  • José Pinazo-Bandera

摘要

Purpose of review

To evaluate the critical role of international registries in understanding idiosyncratic drug-induced liver injury (DILI) by comparing clinical and epidemiological data from the Spanish DILI Registry, the Pro-Euro DILI registry, and the US DILIN.

Recent findings

Although amoxicillin-clavulanic acid remains the leading global DILI trigger, DILI cases in the US show higher severity and more herbal supplement involvement. Immune checkpoint inhibitors present new toxicity phenotypes. Registry collaborations have yielded advanced prognostic tools like the nR criteria for predicting liver failure, and RECAM, a novel electronic causality assessment scale offering greater diagnostic precision than RUCAM.

Summary

Registries are crucial for identifying rare DILI events that are missed by clinical trials, as well as for highlighting regional differences in triggers and outcomes. These networks are essential for identifying diagnostic biomarkers, and their findings benefit not only clinicians, but also regulators. Future research should prioritize the global validation of RECAM and utilize multinational biobanks to identify genetic risk factors, ultimately improving drug safety.