Evidence map›Paper›PMID 42465996›Full record

ArticleFrontiers in pharmacology2026

Severe hepatotoxicity associated with orlistat: clinical presentation, risk factors and outcomes.

Zhuangzhuang Ma, Zhensen Niu, Aiyan Yu, Yuxin Guo, Tianping Chen, Naiju Zhang

Abstract read
In one paragraph

Article in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Zhuangzhuang MaDepartment of Pharmacy, The First Affiliated Hospital of Bengbu Medical University, Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Institute of Emergency and Critical Care Medicine, Branch of National Clinical Research Center for Infectious Diseases, Bengbu, China.
Zhensen NiuDepartment of Pharmacy, The First Affiliated Hospital of Bengbu Medical University, Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Institute of Emergency and Critical Care Medicine, Branch of National Clinical Research Center for Infectious Diseases, Bengbu, China.
Aiyan YuDepartment of Rehabilitation Medicine, Bengbu Infectious Disease Hospital, Bengbu, China.
Yuxin GuoDepartment of Pharmacy, The First Affiliated Hospital of Bengbu Medical University, Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Institute of Emergency and Critical Care Medicine, Branch of National Clinical Research Center for Infectious Diseases, Bengbu, China.
Tianping ChenDepartment of Cardiology, The First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui, China.
Naiju ZhangDepartment of Pharmacy, The First Affiliated Hospital of Bengbu Medical University, Anhui Engineering Technology Research Center of Biochemical Pharmaceutical, Institute of Emergency and Critical Care Medicine, Branch of National Clinical Research Center for Infectious Diseases, Bengbu, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background and Aims: Orlistat, a widely prescribed anti-obesity agent, has been associated with rare but severe hepatotoxicity. The risk profile remains poorly characterised in vulnerable populations, particularly elderly individuals and those with concurrent alcohol use. This study presents a fatal case of OILI and systematically reviews published cases to delineate the clinical spectrum of the injury and highlight features that may be relevant to vulnerable populations. Methods: We report a fatal case of OILI in a 66-year-old man with chronic alcohol use. A systematic literature review was conducted across PubMed, Web of Science, Embase and CNKI up to December 2025 to identify all published cases of OILI. Data on demographics, drug exposure, clinical presentation, laboratory values, and outcomes were extracted and analysed descriptively. Results: Ten cases were analyzed. The median age was 55.5 years (range: 15-66), with a female predominance (80%). Hepatocellular injury was the dominant pattern (nine out of ten). Severe outcomes, including acute liver failure, occurred in 60% (six out of ten) of patients, with a mortality rate of 20% (two out of ten) and 30% (three out of ten) requiring liver transplantation. Both fatalities were males aged ≥60 with alcohol use. Risk factors for severe outcomes included age ≥50 years, alcohol use, and duration of orlistat use >8 weeks. In patients with poor outcomes, transaminases often exceeded 5,000 U/L, bilirubin rose above 171 μmol/L, and INR was greater than 2.0. Conclusion: OILI can present with acute liver failure, particularly in elderly patients with alcohol use. These observations suggest that close monitoring and prompt intervention may be important in high-risk patients, though larger studies are needed to confirm.

Indexed as

acute liver failurealcoholdrug-induced liver injuryelderlyorlistatrisk stratification

Identifiers

PMID42465996
PMCPMC13373584

What Socratic holds

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LicenceCC BY
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Registered trials

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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.