{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T05:21:02Z","timestamp":1774416062221,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T00:00:00Z","timestamp":1771113600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Fundamemntal Clinical Pharma"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Statin\u2010induced liver injury is frequent and usually not severe. The aim of the present study was to describe the safety of statin rechallenge after atorvastatin\u2010induced liver injury because it is poorly documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cases of liver injury involving atorvastatin were selected from the French pharmacovigilance database. Inclusion criteria were a documented atorvastatin or any other statin reintroduction and an available follow\u2010up of at least 2\u2009weeks to define negative rechallenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010six cases of atorvastatin liver injury with further statin reintroduction met our criteria. Median time to onset (TTO) of the first episode was 27\u2009days (IQR: 4\u201343), with a cholestatic pattern in 11 (42.3%) cases, cytolytic in nine (34.6%), and mixed in six (23.1%); severity ranked Grade 2 in 11 (42.3%). Atorvastatin rechallenge was positive in 12 of 16 patients with the same dose (11 of 13) or a reduced dose (1 of 3), and the TTO was shorter (median 11\u2009days). Rechallenge with an alternative statin was performed in 10 patients, of whom two experienced recurrence with rosuvastatin and simvastatin. No recurrence was observed after rechallenge of rosuvastatin in five, pravastatin in two, and simvastatin in one.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study evidenced frequent recurrence of drug\u2010induced liver injury after atorvastatin rechallenge, whereas subsequent administration of a hydrophilic statin was well tolerated. By combining our data and published cases, we suggest that rosuvastatin or pravastatin carries the lowest risk of recurrence. Study limitations include a focus solely on atorvastatin, a retrospective design, and potential underreporting to the pharmacovigilance system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/fcp.70073","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:23:56Z","timestamp":1771201436000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Atorvastatin\u2010Associated Liver Injury: Outcome After Statin Rechallenge"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8655-3786","authenticated-orcid":false,"given":"Blandine","family":"Bertin","sequence":"first","affiliation":[{"name":"Pharmacovigilance Center, Hospital University Pharmacotoxicology Department Hospices Civils de Lyon  Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentine","family":"Lacotte","sequence":"additional","affiliation":[{"name":"Pharmacovigilance Center, Hospital University Pharmacotoxicology Department Hospices Civils de Lyon  Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0787-1469","authenticated-orcid":false,"given":"Jean\u2010Luc","family":"Cracowski","sequence":"additional","affiliation":[{"name":"Pharmacovigilance Unit Grenoble Alpes University Hospital  Grenoble France"},{"name":"HP2 Laboratory, Inserm U1300 Universit\u00e9 Grenoble Alpes  Grenoble France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3358-5650","authenticated-orcid":false,"given":"Anais","family":"Gaiffe","sequence":"additional","affiliation":[{"name":"Franche\u2010Comt\u00e9 Regional Pharmacovigilance and Drug Information Center Besan\u00e7on University Hospital  Besan\u00e7on France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7824-5396","authenticated-orcid":false,"given":"J\u00e9r\u00f4me","family":"Dumortier","sequence":"additional","affiliation":[{"name":"Department of Digestive Diseases, Hospices Civils de Lyon, Edouard Herriot Hospital Claude Bernard Lyon 1 University  Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Vial","sequence":"additional","affiliation":[{"name":"Pharmacovigilance Center, Hospital University Pharmacotoxicology Department Hospices Civils de Lyon  Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,15]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.2183\/pjab.86.484"},{"key":"e_1_2_14_3_1","unstructured":"French National Health Insurance System \u201cOpen Medic: Complete Open Database of the French National Health Insurance System From 2014 to 2023 \u201d accessed January 24 2025 https:\/\/www.assurance\u2010maladie.ameli.fr\/etudes\u2010et\u2010donnees\/open\u2010medic\u2010base\u2010complete\u2010depenses\u2010medicaments."},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11936\u2010009\u20100027\u20103"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27157"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2014.03.002"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.14218\/JCTH.2021.00271"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.5009\/gnl15114"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2008.05.022"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0399\u20108320(04)95062\u20102"},{"key":"e_1_2_14_11_1","first-page":"605","article-title":"Statins and Liver Injury","volume":"9","author":"Thapar M.","year":"2013","journal-title":"Gastroenterolog\u00eda y Hepatolog\u00eda"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gastro.2005.05.006"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40264\u2010024\u201001486\u20106"},{"key":"e_1_2_14_14_1","first-page":"246","article-title":"Hepatotoxicity Associated With Statin Use: Analysis of the Cases Included in the Spanish Hepatotoxicity Registry","volume":"106","author":"Perdices E. 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