Genetic variants associated with susceptibility to liver injury that is caused by lumiracoxib ― a non-steroidal anti-inflammatory drug developed to treat osteoarthritis and acute pain ― are reported this week in Nature Genetics. This suggests that individuals at risk of liver injury could be identified by genotyping and then excluded from lumiracoxib treatment.
Concerns over liver toxicity have led to the withdrawal or non-approval of lumiracoxib in drug markets worldwide. Charles Paulding and colleagues report a genome-wide association study for susceptibility to lumiracoxib-related liver injury in lumiracoxib-treated patients with liver injury and matched lumiracoxib-treated patients without liver injury. They replicated these results identifying genetic variants at the major histocompatibility class II region ― important in the development of the immune system and autoimmunity ― associated with lumiracoxib-related liver injury.