Published today in Clinical Medicine Insights: Therapeutics is a new original research article by Edwin K. Kuffner, Kimberly M. Cooper, Jeffrey S. Baggish, Joseph M. Lynch, Brenda A. Zimmerman, Leslie A. Bloom, Kathleen B. Franklin and Anthony R. Temple.  Read more about this paper below:

Title

Low-Level Alanine Aminotransferase Elevations in Osteoarthritis Patients within Approximately 2 Weeks of Treatment Initiation with Daily Acetaminophen: A Retrospective Analysis Evaluating Subsequent Alanine Aminotransferase Activity on Continued Acetaminophen Therapy

Abstract

Published analyses have noted elevated alanine aminotransferase (ALT) activity in patients taking up to 4000 mg/day of acetaminophen. Data from 3 osteoarthritis trials of acetaminophen 3900–4000 mg/day in which ALT and aspartate aminotransferase (AST) were recorded within approximately 2 weeks of therapy initiation were retrospectively analyzed. Patients with baseline ALT or AST above the upper limit of the reference range (ULRR) were excluded. Among 466 patients, 376 (80.7%) had no ALT elevations within approximately 2 weeks of treatment initiation. Elevations >1.5 and >3.0 times ULRR occurred in 4.5% and 0.9% of patients, respectively. Elevations were transient as most resolved (72.9%) or declined (22.4%) with continued treatment beyond 2 weeks. Within approximately 2 weeks of therapy initiation, no patient had ALT > 5 times ULRR or ALT > 3 times ULRR combined with bilirubin >2 times ULRR. ALT elevations were transient and asymptomatic; almost all resolved or declined while on continued therapy and appear not to be clinically important.

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