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Background <p>With increasing global ageing and spreading trend of polypharmacy, it is crucial to systematically analyze the disease burden and risk factors of DILI in the elderly. The aim of this study was to systematically assess the incidence and risk factors of drug-induced liver injury (DILI) in the elderly.</p> Methods <p>PubMed, Embase and Web of Science databases from 1 January 2000 to 24 March 2025 were systematically searched. Two independent reviewers selected studies, extracted data and assessed risk of bias. The quality of included studies was assessed using the Newcastle-Ottawa scale. Meta-analyses were conducted to quantify the incidence and risk factors of DILI in elderly.</p> Results <p>A total of 16 studies including 8,847 elderly patients with DILI were included. Overall, the incidence of DILI in the elderly population was 25% (95% CI: 18%-31%). In addition, risk factors for DILI in older adults included being female (OR = 1.35, 95% CI: 1.12–1.63; <i>P</i> = 0.003), alcohol use (OR = 2.10, 95% CI: 1.50–2.94; <i>P</i> &lt; 0.001), diabetes mellitus (OR = 1.30. 95% CI: 1.10–1.54; <i>P</i> = 0.008), chronic liver disease (OR = 3.25, 95% CI: 2.20–4.80; <i>P</i> &lt; 0.001), malignancy (OR = 1.80, 95% CI: 1.20–2.70; <i>P</i> = 0.004), antimicrobials (OR = 2.50, 95% CI: 1.90–3.30; <i>P</i> &lt; 0.001), immunosuppressants (OR = 2.20, 95% CI: 1.60-3.00; <i>P</i> &lt; 0.001), and antineoplastics (OR = 3.00, 95% CI: 2.10–4.30; <i>P</i> &lt; 0.001), non-steroidal anti-inflammatory drugs (OR = 1.70, 95% CI: 1.25–2.30; <i>P</i> &lt; 0.001), and antiviral drugs (OR = 1.90, 95% CI: 1.30–2.80; <i>P</i> &lt; 0.001).</p> Conclusion <p>This study systematically quantified the prevalence and risk factors of DILI in the elderly population, highlighting the high risk of chronic liver disease, antineoplastic drugs and antimicrobials.</p> Trial registration <p>Not applicable.</p>

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Epidemiology of drug-related liver injury among the elderly: a systematic review and meta-analysis of incidence, and risk factors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月28日

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  • Yujing Fan,
  • Junfu Zheng,
  • Junnan Gu,
  • Lei Li

摘要

Background

With increasing global ageing and spreading trend of polypharmacy, it is crucial to systematically analyze the disease burden and risk factors of DILI in the elderly. The aim of this study was to systematically assess the incidence and risk factors of drug-induced liver injury (DILI) in the elderly.

Methods

PubMed, Embase and Web of Science databases from 1 January 2000 to 24 March 2025 were systematically searched. Two independent reviewers selected studies, extracted data and assessed risk of bias. The quality of included studies was assessed using the Newcastle-Ottawa scale. Meta-analyses were conducted to quantify the incidence and risk factors of DILI in elderly.

Results

A total of 16 studies including 8,847 elderly patients with DILI were included. Overall, the incidence of DILI in the elderly population was 25% (95% CI: 18%-31%). In addition, risk factors for DILI in older adults included being female (OR = 1.35, 95% CI: 1.12–1.63; P = 0.003), alcohol use (OR = 2.10, 95% CI: 1.50–2.94; P < 0.001), diabetes mellitus (OR = 1.30. 95% CI: 1.10–1.54; P = 0.008), chronic liver disease (OR = 3.25, 95% CI: 2.20–4.80; P < 0.001), malignancy (OR = 1.80, 95% CI: 1.20–2.70; P = 0.004), antimicrobials (OR = 2.50, 95% CI: 1.90–3.30; P < 0.001), immunosuppressants (OR = 2.20, 95% CI: 1.60-3.00; P < 0.001), and antineoplastics (OR = 3.00, 95% CI: 2.10–4.30; P < 0.001), non-steroidal anti-inflammatory drugs (OR = 1.70, 95% CI: 1.25–2.30; P < 0.001), and antiviral drugs (OR = 1.90, 95% CI: 1.30–2.80; P < 0.001).

Conclusion

This study systematically quantified the prevalence and risk factors of DILI in the elderly population, highlighting the high risk of chronic liver disease, antineoplastic drugs and antimicrobials.

Trial registration

Not applicable.