Adjudication Committee

EASL Consortium for the study of Drug and Herbal & Dietary Supplement-Induced Liver Injury” (DHILI)

Adjudication of DILI Cases

Drug-induced liver toxicity (DILI) is a rare and in case of idiosyncratic nature non-predictable cause of acute and chronic liver injury. It includes a wide range of liver toxicity patterns and may resolve spontaneously, become chronic, deteriorate even after stopping the causative agent and in some require specific and non-specific treatment.

Adjudicating DILI cases is an important process for assessing the causality of liver toxicity, especially in the absence of biomarkers or other tests to prove the causal relationship between one or several drugs and an observed liver injury. The adjudication of DILI cases involves a thorough evaluation of the patient’s medical history, clinical findings, laboratory tests, liver histology and imaging studies. It is a complex process that requires expertise in hepatology, clinical pharmacology and toxicology. Adjudication of DILI cases typically involves a panel of experts, including hepatologists, toxicologists, and pharmacologists who review DILI cases in order to determine the cause of liver toxicity.

The primary objective of adjudicating DILI cases is to identify the drug responsible for liver toxicity and to differentiate it from other possible causes of liver injury, such as viral hepatitis, alcoholic liver disease, and autoimmune liver disease. Adjudication of DILI cases also helps in determining the severity of liver toxicity, predicting the risk of progression to chronic liver disease, and guiding the management of patients with DILI.

Adjudicating DILI cases is crucial for DILI-related research projects and especially for the analysis and interpretation of biological samples of DILI patients. Thorough analysis of DILI biosamples will help in identifying new biomarkers to diagnose the disease and to predict its outcome. This will finally lead to the development of safer medications by identifying the mechanisms of drug-induced liver toxicity and providing insights into the potential hepatotoxicity of new drugs. It can also aid in regulatory decision-making by providing evidence for drug safety and efficacy.

ProEuroDILI and TransBioline are European DILI projects. The aim of these projects is the identification, collection and adjudication of DILI cases in Europe and the collection of biosamples of these patients with DILI. Correct case adjudication is a crucial step for the interpretation of all results originating from these cohorts. Case adjudication is performed on a biweekly basis by a team of experts in the fields of hepatology, pharmacology and toxicology.

Members of the Adjudication Committee
  • Prof. Raul Andrade (Malaga, Spain)
  • Prof. Maribel Lucena (Malaga, Spain)
  • Dr. Mercedes Robles Díaz (Malaga, Spain)
  • Prof. Guruprasad Aithal (Nottingham, UK)
  • Dr. Edmond Atallah (Nottingham, UK)
  • Prof. Einar Björnsson (Reykjavik, Iceland)
  • Prof. Gerd Kullak Ublik (Zürich, Switzerland)
  • PD Dr. Guido Stirnimann (Bern, Switzerland)
  • Prof. Alexander Gerbes (München, Germany)
  • PD Dr. Sabine Weber (München, Germany)
  • Prof. Helena Cortez-Pinto (Lisbon, Portugal)
Coordination of case adjudication
  • Dr. Camilla Stephens (Malaga, Spain)