Recovery from liraglutide-induced acute liver injury assessed for causality using the updated RUCAM as global gold standard: A case report and literature review

Liraglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA) widely used for managing type 2 diabetes mellitus (T2DM) and obesity. Reports of liraglutide-associated hepatotoxicity are exceedingly rare. To our knowledge, this is the 9th case of drug-induced liver injury (DILI) caused by liraglutide to be reported. We present a case of a 40-year-old Chinese woman who developed acute liver injury with elevated liver enzymes following 2 weeks of liraglutide treatment for T2DM. Causality was assessed using the updated RUCAM scale, yielding a score of 7, indicating probable DILI, and the diagnosis was further confirmed by liver biopsy. Liver enzyme levels normalized after discontinuing the drug and administering liver-protective treatment within 3 weeks. Furthermore, this case report includes a comprehensive review of all published cases of liraglutide-associated DILI, emphasizing the necessity of regular hepatic-biochemistry monitoring in patients receiving GLP-1 receptor agonists such as liraglutide and providing meaningful evidence regarding their hepatotoxic risk.