Drug Induced Liver Injury Network (DILIN)

DRUG INDUCED LIVER INJURY NETWORK (DILIN):


There is a critical need to develop a means of predicting, detecting and diagnosing drug (or herbal product)-induced liver injury (DILI) in the United States. In 2004, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) established the Drug-Induced Liver Injury Network (DILIN) to conduct clinical and basic science studies of DILI. UNC was one of the charter members of the Network. Dr. Paul Watkins, Professor of Medicine and Toxicology at UNC and the Hamner Institutes for Health Sciences, chairs the DILIN Steering Committee. DILIN now has 8 centers nationwide and has three major study components. UNC participates in all three:

1. DRUG INDUCED LIVER INJURY NETWORK (DILIN): A MULTICENTER, LONGITUDINAL STUDY OF DRUG (AND HERBAL)-INDUCED LIVER INJURY


DILIN continues to grow a nationwide registry of patients who have experienced liver injury from drugs or herbal products. DILIN has enrolled over 1000 patients and UNC is one of the top enrolling centers. Patients are enrolled and follow prospectively. No liver biopsy is necessary and no experimental treatments are given. Only clinical information and blood samples are needed over 2 visits to UNC or one of our satellite sites (Charlotte, Asheville). A full consultation by one of our hepatologists is provided to the referring provider and patient without charge. Travel expenses including lodging (if necessary) are covered. In addition a stipend of $150 is provided to the patient.

2. DRUG INDUCED LIVER INJURY NETWORK (DILIN): IDIOSYNCRATIC LIVER INJURY ASSOCIATED WITH DRUGS (ILIAD)--A RETROSPECTIVE STUDY


In addition to DILIN’s longitudinal study of recent DILI patients, DILIN has a retrospective study as well. In this study, we are building a registry of patients who have had DILI in the last 10 years from any of 8 medications well-known to cause liver injury. The agents are valproate, isoniazid, amoxicillin-clavulanate (Augmentin®), phenytoin (Dilantin®), macrodantin, minocycline, Bactrim/Septra or any fluoroquinolone (e.g levofloxacin, cirprofloxacin). Only record retrieval and blood samples are needed. Patients do not have to come to any of our sites. Participation can be accomplished by phone call, fax and blood draw at any local lab near the patient’s home.

3. DRUG INDUCED LIVER INJURY NETWORK (DILIN): IDENTIFICATION OF NEW BIOMARKERS OF DRUG INDUCED LIVER INJURY


In practice, there is no test that can diagnose DILI with certainty. Using our two registries of patients and blood samples, we hope to develop clinically useful tests that could reliably establish the diagnosis of DILI and identify the responsible drug. Therefore, having a large registry of well-defined cases of DILI is critical.

Any patient who may have had a liver injury or toxicity event related to a medication, herbal product, nutritional supplement, complimentary/alternative medical or health enhancing agent may qualify for DILIN and so we’d like to hear about them.

Please contact us at the following numbers or emails:
Paul H. Hayashi, MD, MPH: 919-966-2516 or
paul_hayashi@med.unc.edu
Tracy Russell, CCRP: 919-843-2376 or
trussell@med.unc.edu

For more information on DILIN nationwide, go to https://dilin.dcri.duke.edu/