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Bulletin of the National Research Centre

Table 4 Drug-induced liver injury secondary to SARMs

From: Metabolic and hormonal dysfunction in asymptomatic patient using selective androgen receptor modulators: a case report

References

Patient age/sex

SARM

Duration

Presenting symptoms

Initial/peak bilirubin

Initial ALT/AST/ALP

Peak ALP

Initial/ peak R-factor*

Type of liver injury

RUCAM (or DILIN) score

Manage-ment

Flores et al. (2020) (2 case reports)

1. 24 years M

2. 49 years M

1. LGD-4033

2. RAD-140

1. 9 weeks

2. 4 weeks

Jaundice, nausea, lethargy, weight loss

1. 6.78/6.78

2. 17/20.2

1. 589/175/197

2. 200/111/111

1. 289

2. 327

1. 8.2/1.6

2. 5.0/0.5

1. Mixed/cholestatic

2. Mixed/cholestatic**

1. 7

2. 6

SARM cessation, supportive care

Barbara et al. (2020)

32 years M

LGD-4033

2 weeks

Jaundice, fatigue, pruritis, weight loss

35/38.2

229/91/88

525

–/–

Mixed/cholestatic**

–

SARM cessation, supportive care

Barbara et al. (2020)

52 years M

RAD-140/LGD-4033

7 weeks

Jaundice, RUQ pain, pruritis, diarrhea

34.5/34.5

46/36/529

529

0.2/0.2

Cholestatic**

–

SARM cessation, supportive care

Bedi et al. (2021)

“Early 40’s” years M

MK-2866

8  weeks

Jaundice, weight loss, lethargy, diarrhea

19.9/43

112/69/268

> 400

0.8/–

Cholestatic**

–

SARM cessation, supportive care

Akhtar et al. (2021)

 

RAD-140/LGD-4033/MK-2866

24 weeks

Jaundice, abdominal pain, pruritis

6.9/34

115/61/173

434

–/–

Cholestatic

–

SARM cessation, supportive care

Koller et al. (2021) (2 case reports)

1. 19 years M

2. 28- years M

1. LGD-4033

2. LGD-4033/MK-2866

1. 4 weeks

2. 12 weeks

1. Jaundice

2. Jaundice, nausea, fatigue

1. 238/238

2. 401/401

1. 132/–/92.4

2. 144/–/92.4

1. 92.4

2. 131

1. 3.9/3.9

2. 3.9/2.0

1. Mixed**

2. Mixed/cholestatic**

1. 6

2. –

SARM cessation, supportive care

Khan et al. (2022)

29 years M

Unspecified

4  weeks

Jaundice, icterus, pruritis, fatigue

16.9/22.6

165/79/213

305

–/–

Cholestatic**

(DILIN causality 1; severity 3 +)

SARM cessation, supportive care

Leung et al. (2022)

24 years M

RADO-140

5 weeks

Jaundice, icterus, abdominal pain, pruritis

1.2/38.5

313/182/103

251

4.4/1.2

Mixed/cholestatic**

(DILIN causality 1; severity 2)

SARM cessation, supportive care

Lee et al. (2022)

23 years M

LGD-4033/RAD-140/YK-11

12 weeks

Jaundice, icterus, pruritis, loss of appetite

29.2/36.37

148/88/151

290

0.8/–

Cholestatic

6

SARM cessation, supportive care

Present case, 2022

27 years M

LGD-4033/S-23

8 weeks

None

0.8/0.8

144/75/56

73

7.3/7.3

Hepatocellular

6

SARM cessation, supportive care

  1. SARM, Selective Androgen Receptor Modulator; ALP, alkaline phosphatase; ALT, alanine transaminase; AST, aspartate aminotransferase; RUQ, right upper quadrant
  2. LGD-4033 (Ligandrol), MK-2866 (Ostarine or Enobosarm), RAD-140 (Testolone); RUCAM, Roussel Uclaf Causality Assessment Method
  3. *Peak R-factor refers to R-factor when patient’s ALP was the highest during the hospital course. Not all R-factors were reported and could not be calculated if reference ranges for laboratory normal values were not provided
  4. **Liver biopsy confirmed diagnosis
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