Drug-Induced Liver Injury Associated with Ezetimibe Therapy

Excerpt

Ezetimibe is the first lipid-lowering drug that inhibits intestinal uptake of dietary and biliary cholesterol without affecting the absorption of fat-soluble nutrients and was approved by US Food and Drug Administration in the fall of 2002 as a therapy for hypercholesterolemia in combination with a statin or alone [1]. Clinical trials and other studies on the efficacy and safety of ezetimibe have shown that ezetimibe causes biochemical abnormality of liver function, elevated serum transaminase activity ≥3 times the upper limit of the reference range in <1% of the treatment group [2‐4]. All such patients with elevated liver enzymes have been asymptomatic thus far, and the findings were entirely reversible. It has been reported, however, that 1 patient developed an acute autoimmune-like hepatitis during the combination therapy with atorvastatin and ezetimibe, and ezetimibe was suspected to be the causal agent [5]. We report a case of drug-induced liver injury (DILI) during treatment with ezetimibe alone and review the histopathologic features of acute DILI. …