Letter to the Editor
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 28, 2021; 27(48): 8370-8373
Published online Dec 28, 2021. doi: 10.3748/wjg.v27.i48.8370
Strategy for the control of drug-induced liver injury due to investigational treatments/drugs for COVID-19
Ken Sato, Yuichi Yamazaki, Toshio Uraoka
Ken Sato, Yuichi Yamazaki, Toshio Uraoka, Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi 371-8511, Gunma, Japan
Author contributions: Sato K designed the research and drafted the article; Yamazaki Y and Uraoka T analyzed the data and gave critical advice; and Sato K revised the letter and performed the final approval of the version of the article to be published.
Conflict-of-interest statement: We received no financial support for this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ken Sato, MD, PhD, Associate Professor, Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan. satoken@gunma-u.ac.jp
Received: July 29, 2021
Peer-review started: July 29, 2021
First decision: November 7, 2021
Revised: November 18, 2021
Accepted: November 10, 2021
Article in press: December 10, 2021
Published online: December 28, 2021
Abstract

Investigational treatments/drugs for coronavirus disease 2019 (COVID-19) have been applied, with repurposed or newly developed drugs, and their effectiveness has been evaluated. Some of these drugs may be hepatotoxic, and each monotherapy or combination therapy may increase the risk of drug-induced liver injury (DILI). We should aim to control dysregulation of liver function, as well as the progression of COVID-19, as much as possible. We discussed the potential risks of investigational treatments/drugs and promising drugs for both COVID-19 and DILI due to investigational treatments/drugs.

Keywords: Coronavirus disease 2019, Drug-induced liver injury, Cytochrome P450, Drug-drug interaction, Drug-disease interaction, Cytokine

Core Tip: To cope with dysregulation of liver function in coronavirus disease 2019 (COVID-19), drug-induced liver injury (DILI) due to investigational treatments/drugs or drug-drug or drug-disease interactions should be considered. We described useful information associated with clinical practice. We discussed the potential hepatotoxicity of dexamethasone or remdesivir as representative investigational treatments/drugs for COVID-19. These drugs are predicted to be used for a certain time in monotherapy or combination therapy. We also reported glycyrrhizic acid and ursodeoxycholic acid as therapeutic candidates for the control of DILI due to investigational treatments/drugs, as well as COVID-19.