ported that oral antidiabetic agents may sometimes induce hepatic injury. We therefore investigated the influence of α-glucosidase inhibitor (α-GI) on the liver functions, both retrospectively and prospectively.
1. From January, 1996 to July, 1998, 222 patients received Voglibose (VOG: 132) or Acarbose (ACA: 90) at an outpetient Clinic of the Internal Medicine Department for Endocrine Diseases of Tokyo Metropolitan Futyu Hospital.
2. VOG was found to be induce the hepatic injury in 3 patients within 1 month from the start of administration, and in 3 patients within 3 months. The rise in the ALT level was higher than that of the AST level, but it wes slight and transitory.
3. One patient administered VOG (0.9 mg/day) showed significant changes in his hepatic functions, and at 84 days the following levels were seen: AST rose 801 IU/L, ALT 1104 IU/L, LDL 907, IU/L.
4. In a literature review, hepatic injury was reported in 14 ACA-treated patients, and appeared in 10 of them within 3 months. In 0.6 mg/day VOG-treated patients, one patientshowed hepatic injury within 1 month, and one patient within 3 months. In Pharmaceuticals and Medical Devices Safety Information, hepatic injury was reported in 57 ACA-treated patients, and appeared in 44 of them within 6 months. In VOG-treated patients, hepatic injury was reported in 20 patients, and appeared in 17 of them within 3 months.
The incidence of α-GI-induced hepatic injury is low but unpredictable, however, if it does occur the condition often serious. As a result, periodical hepatic function tests should be performed at least monthly, for at least 6 months after the administration ACA and for 3 months after VOG.
