Efficacy and Safety of Compound Glycyrrhizin in the Treatment of Drug- Induced Liver Injury in Pediatric Cancer Patients: A Retrospective Cohort Study

Background Drug-induced liver injury (DILI) caused by chemotherapy poses significant health risks for pediatric cancer patients and remains a serious clinical challenge. Currently, there are no clearly recommended pharmacological treatments specifically for managing DILI in children. Here, we assessed the efficacy and safety of Compound glycyrrhizin (CG) in treating DILI among children with cancer. Methods Data from a retrospective cohort study were analyzed to compare CG and magnesium isoglycyrrhizinate (MgIG) for treatment of DILI. We used the Roussel Uclaf causality assessment method (RUCAM) to evaluate patients with DILI. Patients with RUCAM scores ≥ 6 were included in the study. Propensity score matching was used to balance the baseline characteristics. The primary outcome was the proportion of patients with alanine aminotransferase (ALT) normalization at week 4 after CG and MgIG administration. The safety comparison between the two drugs was conducted by analyzing records of drug-related adverse events. Result A total of 234 eligible subjects were enrolled into two groups: 117 in the CG group and 117 in the MgIG group. Overall, 68.38% of patients in the CG group and 69.23% in the MgIG group achieved ALT normalization at week 4, with no statistically significant difference between the groups. ALT normalization rates increased gradually over time in both groups, yet no significant differences were observed at weeks 1, 2, or 3. Median ALT levels declined from baseline throughout the 4-week treatment period in both groups; however, differences between groups remained statistically insignificant at all time points. Similarly, the proportion of AST normalization showed no significant intergroup differences. Notably, a greater reduction in AST levels was observed in the MgIG group at week 3 (P = 0.032), but this difference was not maintained by week 4. In terms of safety, adverse events occurred in 1.71% of patients in the CG group and 5.12% in the MgIG group, without significant differences ( P  = 0.281). Conclusion The efficacy and safety of CG and MgIG for treatment of DILI were comparable in children with cancer. This study provided preliminary evidence that CG is an effective and safe treatment for children with chemotherapy-induced liver injury.