Effectiveness and safety of medications among patients with liver disease
The liver plays a major role in pharmacokinetics, the field of pharmacology studying how the body affects a drug,
and particularly in the processes of drug metabolism and drug elimination. Hence, decreased hepatic function due
to liver disease can affect systemic drug levels and potentially drug effectiveness and safety. Moreover, patients
with liver disease are often at increased risk of adverse clinical outcomes. However, patients with liver disease
are underrepresented or even systematically excluded from randomized controlled trials, the gold standard when it
comes to the assessment of drug efficacy. Therefore, pharmacoepidemiologic studies can provide needed evidence on
the effectiveness and safety of medications in this high-risk population.
To help fill in this important knowledge gap, we are currently studying together with colleagues at McGill University
in Montreal the effectiveness and safety of direct oral anticoagulants (DOACs) among patients with non-valvular atrial
fibrillation and liver disease. This project is funded by a Project Grant from the Canadian Institutes of Health Research.
Futures studies by our lab in the area will focus on the effectiveness and safety of other cardiovascular medications
among patients with liver disease and specifically non-alcoholic fatty liver disease and cirrhosis.