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Acute liver injury due to flavocoxid (Limbrel), a medical food for osteoarthritis: a case series.

ABSTRACT: Flavocoxid is a prescription medical food that is used to treat osteoarthritis. It is a proprietary blend of 2 flavonoids, baicalin and catechins, which are derived from the botanicals Scutellaria baicalensis and Acacia catechu, respectively.To describe characteristics of patients with acute liver injury suspected of being caused by flavocoxid.Case series.Drug-Induced Liver Injury Network Prospective Study ongoing at multiple academic medical centers since 2004.Four adults with liver injury.Clinical characteristics, liver biochemistry values, and outcomes.Among 877 patients enrolled in the prospective study, 4 had liver injury suspected to have been caused by flavocoxid. All were women; ages ranged from 57 to 68 years. All developed symptoms and signs of liver injury within 1 to 3 months after initiating flavocoxid. Liver injury was characterized by marked elevations in levels of alanine aminotransferase (mean peak, 1268 U/L; range, 741 to 1540 U/L), alkaline phosphatase (mean peak, 510 U/L; range, 286 to 770 U/L), and serum bilirubin (mean peak, 160.7 µmol/L [9.4 mg/dL]; range, 34.2 to 356 µmol/L [2.0 to 20.8 mg/dL]). Liver biochemistry values decreased to the normal range within 3 to 12 weeks after flavocoxid was stopped, and all patients recovered without experiencing acute liver failure or chronic liver injury. Causality was adjudicated as highly likely in 3 patients and as possible in 1 patient.The frequency and mechanism of liver injury could not be assessed.Flavocoxid can cause clinically significant liver injury, which seems to resolve within weeks after cessation.

SUBMITTER: Chalasani N

PROVIDER: S-EPMC3825458 | biostudies-literature | 2012 Jun

REPOSITORIES: biostudies-literature

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Acute liver injury due to flavocoxid (Limbrel), a medical food for osteoarthritis: a case series.

Chalasani Naga N Vuppalanchi Raj R Navarro Victor V Fontana Robert R Bonkovsky Herbert H Barnhart Huiman H Kleiner David E DE Hoofnagle Jay H JH

Annals of internal medicine 20120601 12

<h4>Background</h4>Flavocoxid is a prescription medical food that is used to treat osteoarthritis. It is a proprietary blend of 2 flavonoids, baicalin and catechins, which are derived from the botanicals Scutellaria baicalensis and Acacia catechu, respectively.<h4>Objective</h4>To describe characteristics of patients with acute liver injury suspected of being caused by flavocoxid.<h4>Design</h4>Case series.<h4>Setting</h4>Drug-Induced Liver Injury Network Prospective Study ongoing at multiple ac ...[more]

PMID: 22711078

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Project description:BackgroundAcute Kidney Injury (AKI) is a major and under-recognised cause of morbidity and mortality worldwide. Low and middle-income countries bear the greatest burden of AKI (85%). There is currently no published literature on AKI from the Pacific Islands. The aim of the present study was to report the incidence, aetiology, management and outcomes measures of AKI from the tertiary referral hospital of Samoa.Materials and methodsSingle-centre prospective observational study. Participants were recruited by the lead investigator from the hospital patient information system. The inclusion criteria for participation was (1) adults (>18 years) admitted to general wards of Tupua Tamasese Meaole (TTM) Hospital with a diagnosis of AKI between December 1, 2019 and May 31, 2020, and (2) serum creatinine level of >200 μmol/L, and (3) compliance with the current Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI diagnosis. The data collection form was adapted from the International Society for Nephrology - Global Snapshot Project, and recorded demographic and baseline characteristics, precipitating causes of AKI, treatment/management, and outcomes measures.ResultsThere was a total of 114 AKI admissions over the study period corresponding to a hospital-based AKI incidence of 26.8 per 1000 admissions per 6 months. 75% of AKI cases were community acquired. The leading causes of AKI were dehydration (79%) and sepsis (64%). More than 40% of cases presented with two or more Non-Communicable Disease co-morbidities. The in-patient mortality rate was 20.2%. In the 3 months following discharge from hospital, 25% of AKI cases had completely resolved, 25% of patients had died, and 18.7% of AKI cases had progressed to chronic kidney disease. The leading causes of mortality were cardiovascular events (35%) and sepsis (35%).ConclusionsThe hospital-based incidence and unfavourable outcomes of AKI are high in Samoa. Greater awareness of this under-recognised condition is warranted among the public, government officers, and health professionals.

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Acute liver injury due to flavocoxid (Limbrel), a medical food for osteoarthritis: a case series.

Publications

Acute liver injury due to flavocoxid (Limbrel), a medical food for osteoarthritis: a case series.

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