%0 Generic %A A., Wree %A A., Dechêne %A K., Herzer %A P., Hilgard %A W.-K., Syn %A G., Gerken %A A., Canbay %D 2011 %T Supplementary Material for: Steroid and Ursodesoxycholic Acid Combination Therapy in Severe Drug-Induced Liver Injury %U https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Steroid_and_Ursodesoxycholic_Acid_Combination_Therapy_in_Severe_Drug-Induced_Liver_Injury/5121553 %R 10.6084/m9.figshare.5121553.v1 %2 https://karger.figshare.com/ndownloader/files/8706133 %K Drug-induced liver injury %K Ursodesoxycholic acid %K Acute liver failure %X Background: Drug-induced liver injury (DILI) is the leading cause of acute severe liver disease in Western countries. Treatment strategies for DILI are still not well defined. Aim: We studied the safety and outcomes of steroid/ursodesoxycholic acid (UDCA) combination therapy in DILI patients. Patients, Materials and Methods: 15 consecutive patients with severe DILI were analyzed for clinical, biochemical and histological data. Nine patients were treated with a steroid step-down therapy with reduction of the daily dose over several weeks; 6 patients received a steroid pulse therapy for 3 days. UDCA was administered for several weeks in both groups. Results: Patients without histological signs of preexistent liver damage (n = 10) showed the most favorable clinical course. Bilirubin and serum transaminases dropped to <50% of peak values within 2 weeks, and normalized within 4–8 weeks. In contrast, patients with positive autoimmune antibodies (anti-nuclear antibodies and/or soluble liver antigen) and/or histological features of chronic hepatitis (n = 3) exhibited a slower reduction in bilirubin and serum transaminase levels. These patients were given immunosuppressants (steroids, azathioprine) for a further 6 months. Conclusion: Treatment of severe DILI with corticosteroids (both pulse and step-down therapy) and UDCA appears to be safe, and leads to a more rapid reduction in bilirubin and transaminases after DILI. %I Karger Publishers