Olanzapine-Associated Hepatotoxicity in Bipolar Disorder: A Multicenter Real-World Study of Prevalence, Risk Factors, and Outcomes

作者：Fang Wang, Xin Lai, Shihai Zhou, J I N Y I Lin, Hao Xin, Zhengnan Tao, Xiaolu Wang, Sitian Zhang, Z LIU, Huawei Tan, Yuanguo Xiong · 发表于：Drug Design Development and Therapy · 年份：2026 · DOI：10.2147/dddt.s598447 · 被引用次数：1 · 研究领域：Bipolar Disorder and Treatment、Drug-Induced Hepatotoxicity and Protection、Treatment of Major Depression

Background: Olanzapine, an atypical antipsychotic agent, is widely used in the treatment of bipolar disorder due to its multifaceted therapeutic effects, encompassing sedation, mood stabilization, and antidepressant activity. Nevertheless, safety concerns remain a critical consideration in clinical application. Objects: This real-world, multicenter retrospective cohort study aimed to investigate the prevalence, risk factors, clinical patterns, and outcomes of olanzapine-associated hepatotoxicity in bipolar disorder patients. Methods: We conducted a multicenter retrospective cohort study was conducted across three tertiary hospitals, enrolling bipolar disorder patients (DSM-5 criteria) treated with olanzapine between January and December 2023. Demographics, treatment details, and laboratory data were extracted from electronic records. Univariate and multivariate logistic regression analyses identified risk factors for olanzapine-associated liver injury. Results: Hepatotoxicity, defined according to the Common Terminology Criteria for Adverse Events (CTCAE) criteria, was the primary endpoint and occurred in 118 of 487 hosptialized patients (24.2%), with the majority classified as mild (19.3%). Injury patterns were predominantly mixed in mild-to-moderate cases and hepatocellular in severe cases. Multivariate analysis identified higher daily dosage (OR: 1.070, 95%CI: 1.006– 1.138, P =0.030) and elevated gamma-glutamyl transferase (GGT) (OR: 1.022, 95%CI: 1.006– 1.139, P =0.007) a...