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Drug Induced Liver InjuryNCT06922669

Glucocorticoids for Acute Drug Induced Liver Injury With Hyperbilirubinemia

A study testing Methylprednisolone, Magnesium isoglycyrrhizinate and Glutathione in people with Drug Induced Liver Injury, run by General Hospital of Shenyang Military Region at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Drug-induced liver injury (DILI) can lead to potentially fatal complications, such as acute liver failure and even death. In clinical practice, glucocorticoids have been considered in some cases of DILI, especially patients with hyperbilirubinemia. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Drug Induced Liver Injury
What is being tested?
Methylprednisolone, Magnesium isoglycyrrhizinate and Glutathione
Could I receive a placebo?
No, everyone receives an active treatment
How many people
232 participants
Where
1 siteChina
Study dates
24 Jun 2025to 30 Sep 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • A definite diagnosis of acute DILI;
  • 5×ULN ≤ TBIL level at baseline ≤ 20×ULN;
  • Age 18-80 years old;
  • Sign the informed consent form.

Who cannot join

  • Other causes of liver injury, including viral hepatitis, cytomegalovirus infection, Epstein-Barr virus infection, Herpes virus infection, autoimmune liver disease, alcoholic liver disease, hypoxic/ischemic liver disease, Budd-Chiari syndrome, biliary tract disease, Wilson's disease, hemochromatosis, and α1-antitrypsin deficiency;
  • Immune checkpoint inhibitors or gynura segetum induced DILI;
  • Absolute contraindications to glucocorticoids, such as systemic mold infections or allergies;
  • A history of glucocorticoid therapy within 3 months before enrollment;
  • A history of diseases requiring glucocorticoid maintenance therapy, such as rheumatoid arthritis, systemic lupus erythematosus, systemic dermatomyositis, etc;
  • A history of liver transplantation;
Show all 18Show fewer
  • Received artificial liver therapy before enrollment;
  • Malignant tumor of the liver, bile duct, pancreas or liver metastasis
  • Acute liver failure;
  • Renal dysfunction, creatinine Cr≥133μmol/L;
  • Neutrophil count <1,000,000,000/L;
  • Active tuberculosis;
  • Severe cardiopulmonary diseases;
  • Recent surgery or trauma;
  • Mental illness;
  • Pregnancy or lactation;
  • Participated in other clinical studies within 3 months before enrollment;
  • Other conditions judged by the clinician to be inappropriate for study participation.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Qianqian Li contact

13940307473

1208594776@qq.com

China1 site, 1 recruiting
  • Department of Gastroenterology, General Hospital of Northern Theater Command (formerly called General Hospital of Shenyang Military Area)

    Shenyang, Liaoning, 110840

    Xingshun Qi, 18909881019, xingshunqi@126.com

    Qianqian Li, 13940307473, 1208594776@qq.com

    Recruiting

Other trials in China

About this study

Official title: Efficacy and Safety of Glucocorticoids for Acute Drug Induced Liver Injury With Hyperbilirubinemia: A Multicenter Randomized Controlled Trial

Drug-induced liver injury (DILI) can lead to potentially fatal complications, such as acute liver failure and even death. In clinical practice, glucocorticoids have been considered in some cases of DILI, especially patients with hyperbilirubinemia. However, the available evidence remains controversial and its quality is also very limited. Herein, a multicenter randomized controlled trial (RCT) has been designed to explore the efficacy and safety of glucocorticoids in patients with acute DILI and hyperbilirubinemia.

Read the detailed description

Overall, 232 patients with acute DILI with hyperbilirubinemia will be enrolled. They will be randomly assigned at a ratio of 1:1 to the conventional treatment alone or combined with glucocorticoids groups. The primary endpoint is the improvement of DILI after treatment on second week. Secondary endpoints include the improvement of DILI on fourth week, rates of progressive liver injury, liver failure, liver transplantation, survival, and adverse events. Exploratory endpoints will assess the beneficial population and changes of inflammatory factors following glucocorticoid treatment.

Being tested
Methylprednisolone, Magnesium isoglycyrrhizinate, Glutathione, Silymarin, Polyene Phosphatidylcholine
Keywords
Drug induced liver injury, liver failure, glucocorticoids, clinical trial, Hyperbilirubinemia
Medical subject headings
Chemical and Drug Induced Liver Injury, Liver Failure, Hyperbilirubinemia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MethylprednisoloneDrug

    Also called Medrol

    Initially, an intravenous dose of 1 mg/kg/day of methylprednisolone will be administered for one week, with the possibility of extending treatment to two weeks if necessary. Following this, participants will receive oral methylprednisolone tablets, starting at a dose of 40 mg/day. The oral dosage will be gradually tapered based on the participants' condition over a period of 1 to 3 months.

  • Magnesium isoglycyrrhizinateDrug

    It is suitable for patients with hepatocellular or mixed DILI. A daily dose of 0.15g to 0.2g

  • GlutathioneDrug

    It is suitable for patients with hepatocellular or mixed DILI. A daily dose of 1.2g to 1.8g

  • SilymarinDrug

    Also called Legalon

    It is suitable for patients with hepatocellular or mixed DILI. The dosage is 140 mg, taken 2 to 3 times per day.

  • Polyene PhosphatidylcholineDrug

    Also called Essentiale

    It is suitable for patients with hepatocellular or mixed DILI. The dosage is 228mg-456mg, taken 3 times per day.

  • Ursodeoxycholic acid capsulesDrug

    Also called Ursofalk

    It is suitable for patients with cholestatic or mixed DILI. A daily dose of 10mg-15mg/kg/day.

  • Ademetionine 1,4-ButanedisulfonateDrug

    Also called Transmeti

    It is suitable for patients with cholestatic or mixed DILI. A daily dose of 0.5g to 1g.

  • Plaslna exchangeProcedure or surgery

    Also called Artificial liver support

    It is suitable for patients whose condition continues to worsen or even develop to liver failure.

  • Liver transplantationProcedure or surgery

    It is suitable for patients whose condition continues to worsen or even develop to liver failure.

Study groups in NCT06922669
Study groupRoleWhat they receive
Glucocorticoids groupExperimentalGlucocorticoids step-down therapy combined with conventional treatment.
Receives: Drug: Methylprednisolone; Drug: Magnesium isoglycyrrhizinate; Drug: Glutathione; Drug: Silymarin; Drug: Polyene Phosphatidylcholine; Drug: Ursodeoxycholic acid capsules; Drug: Ademetionine 1,4-Butanedisulfonate; Procedure: Plaslna exchange; Procedure: Liver transplantation
Conventional treatmentActive comparatorOnly conventional treatment according to the Chinese practice guidelines regarding the management of DILI.
Receives: Drug: Magnesium isoglycyrrhizinate; Drug: Glutathione; Drug: Silymarin; Drug: Polyene Phosphatidylcholine; Drug: Ursodeoxycholic acid capsules; Drug: Ademetionine 1,4-Butanedisulfonate; Procedure: Plaslna exchange; Procedure: Liver transplantation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Improvement of DILI on the second week

    TBIL level decreases by 50% as compared to the baseline level.

    Measured: 2 weeks

Secondary outcomes (9)
  1. Improvement of DILI on the fourth week

    TBIL level decreases by 50% as compared to the baseline level.

    Measured: 4 weeks

  2. Progressive liver injury on the second week

    TBIL level increases as compared to the baseline level.

    Measured: 2 weeks

  3. Progressive liver injury on the fourth week

    TBIL level increases as compared to the baseline level.

    Measured: 4 weeks

  4. Improvement of liver enzymes on the second week

    Proportion of 50% reduction from baseline in ALT, AST, ALP, and GGT levels.

    Measured: 2 weeks

  5. Improvement of liver enzymes on the fourth week

    Proportion of 50% reduction from baseline in ALT, AST, ALP, and GGT levels.

    Measured: 4 weeks

  6. Liver failure

    Participants develop overt hepatic encephalopathy with an INR of ≥1.5.

    Measured: 3 months

  7. Liver transplantation

    Participants undergo liver transplantation due to liver failure.

    Measured: 3 months

  8. Survival

    All participants will be followed by telephone to record survival status, including the major cause and date of death.

    Measured: 3 months

  9. Adverse events

    Adverse events related to glucocorticoids mainly include infection, water-sodium retention, Cushing syndrome, poor glycemic, gastrointestinal ulcer, thromboembolic disease, neuropsychiatric symptoms, osteoporosis, increased intraocular pressure, and withdrawal syndrome. They will be closely recorded during the period of glucocorticoids treatment.

    Measured: 3 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Apr 2025
  2. Study start24 Jun 2025
  3. Primary completion31 Mar 2027 (estimated)
  4. Study completion30 Sep 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
232 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06922669
Sponsor's protocol ID
XHNKKY-ASDILI-RCT
Status last verified
Dec 2025
First submitted
3 Apr 2025
Last updated
18 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Hou FQ, Zeng Z, Wang GQ. Hospital admissions for drug-induced liver injury: clinical features, therapy, and outcomes. Cell Biochem Biophys. 2012 Nov;64(2):77-83. doi: 10.1007/s12013-012-9373-y.

    PubMed 22806342
  • Hu PF, Wang PQ, Chen H, Hu XF, Xie QP, Shi J, Lin L, Xie WF. Beneficial effect of corticosteroids for patients with severe drug-induced liver injury. J Dig Dis. 2016 Sep;17(9):618-627. doi: 10.1111/1751-2980.12383.

    PubMed 27426618
  • Chai L, Wang R, Teschke R, Jin S, Deng J, Qi X. Successful corticosteroid therapy for severe liver injury secondary to herbal traditional Chinese medicine, Mega Defends X, assessed for causality by the updated RUCAM: A case report. Medicine (Baltimore). 2024 Aug 23;103(34):e39439. doi: 10.1097/MD.0000000000039439.

    PubMed 39183394
  • Mao Y, Ma S, Liu C, Liu X, Su M, Li D, Li Y, Chen G, Chen J, Chen J, Zhao J, Guo X, Tang J, Zhuge Y, Xie Q, Xie W, Lai R, Cai D, Cai Q, Zhi Y, Li X; Technology Committee on DILI Prevention, Management, Chinese Medical Biotechnology Association; Study Group on Drug-Induced Liver Disease, Chinese Society of Hepatology, Chinese Medical Association. Chinese guideline for the diagnosis and treatment of drug-induced liver injury: an update. Hepatol Int. 2024 Apr;18(2):384-419. doi: 10.1007/s12072-023-10633-7. Epub 2024 Feb 24.

    PubMed 38402364
  • Li Q, Lin Y, Zeng X, Zhou L, Wang F, Ye Q, Gao Y, Guo L, Zhu J, Li J, Li Y, Shao L, Hu Y, Xiao J, Jia A, Wang D, Chang L, Wang J, Zhang J, Wang R, Gao F, Wu Q, Hu P, Zhu C, Cai L, Ran Y, Li Y, Zhang J, Ran Y, Wang C, Wang N, Zhang J, Zhang X, Li J, Sun J, Chu Y, Ma Y, Wang T, Zheng Z, Shen Y, Qi X, Xie W. Efficacy and safety of glucocorticoids for acute drug-induced liver injury with hyperbilirubinemia: protocol of a multicenter randomized controlled trial. Ther Adv Gastroenterol. 2026 Apr 26;19:17562848261440777. doi: 10.1177/17562848261440777. eCollection 2026.

    PubMed 42080196

Questions about this trial

What is this clinical trial studying?

A study testing Methylprednisolone, Magnesium isoglycyrrhizinate and Glutathione in people with Drug Induced Liver Injury, run by General Hospital of Shenyang Military Region at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 18 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Xingshun Qi (18909881019, xingshunqi@126.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Improvement of DILI on the second week (time frame: 2 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06922669, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Dec 2025.

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