Evidence map›Paper›PMID 40762948›Full record

ReviewDrug safety2026

The Impact of COVID-19 and COVID-19 Vaccination on Detection, Assessment, and Management of Suspected Acute Drug-Induced Liver Injury Occurring during Clinical Trials: Consensus Recommendations from the IQ DILI Initiative.

Melissa Palmer, Daniel Seekins, Mark Avigan, John Marcinak, Don C Rockey, Arie Regev, Vineet K Shastri, James H Lewis, Ajit Dash

Abstract readConsensus StatementReview
In one paragraph

Review in Drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Melissa Palmer *Liver Consulting LLC, New York, USA.
Daniel Seekins *Patient Safety, Bristol-Myers Squibb, Lawrenceville, NJ, USA.
Mark AviganCenter for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA.
John MarcinakPharmacovigilance and Patient Safety, AbbVie, North Chicago, IL, USA.
Don C RockeyDigestive Disease Research Center, Charleston, SC, USA.
Arie RegevGlobal Patient Safety, Eli Lilly and Company, Indianapolis, IN, USA.
Vineet K ShastriGlobal Patient Safety, Amgen, Thousand Oaks, CA, USA.
James H LewisDivision of Gastroenterology, Georgetown University, Washington, DC, USA.
Ajit DashEarly Development Safety, Genentech, Inc., South San Francisco, CA, USA. dash.ajit@gene.com.ORCID 0000-0003-4033-4614

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

While the acute impact of the coronavirus disease 2019 (COVID-19) pandemic has waned, implications for clinical trials remain. In particular, guidance for evaluation of elevated liver tests due to COVID-19, its treatments, and COVID-19 vaccination is lacking. The IQ DILI Initiative, composed of experts from academia, regulatory agencies, and industry herein propose recommendations to address this gap. Extensive literature review was conducted and structured discussions were held between IQ DILI industry members, regulators, and academic experts in hepatology and DILI. Liver-related manifestations in nonhospitalized patients with COVID-19 are highly varied. Evidence of liver injury may occur after COVID-19 symptoms resolve and testing is negative. Treatments for COVID-19 may cause liver injury or alter pharmacokinetics. COVID-19 vaccination has been associated with rare but clear hepatotoxicity, typically consistent with drug-induced autoimmune-like hepatitis, although other presentations, severity, latency, and time to resolution have been reported. Liver injury occurred with mRNA and viral vector vaccines, and in individuals with and without underlying autoimmune or liver diseases. Drug developers and investigators should be aware of the potential liver-related manifestations related to COVID-19, its treatments, and COVID-19 vaccination, as this may impact study eligibility and causality assessment during a trial. COVID-19 testing should be considered part of DILI causality assessment, as a positive test may prevent premature termination of the investigational drug. Since clinical trial participants may not consider vaccinations in their medical history, specific inquiry about their receipt is important when liver tests are abnormal during screening and as part of DILI causality assessment.

Indexed as

Chemical and Drug Induced Liver InjuryCOVID-19COVID-19 VaccinesClinical Trials as TopicHumansSARS-CoV-2VaccinationCOVID-19 Vaccines

Identifiers

PMID40762948
PMCPMC12804223

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.