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Review of high-risk factors Previous studies have shown that the development of DILI depends not only on the offending drug but also on host-related risk factors, including advanced age, female sex, pre-existing or concomitant liver disease, metabolic syndrome and diabetes, heavy alcohol use, polypharmacy, and genetic susceptibility mediated by specific HLA alleles ( For SJS/TEN, major risk factors include genetic susceptibility (e.g., HLA-B15:02, HLA-B58:01), HIV infection, malignancy or autoimmune disease, chronic renal impairment, older age, and exposure to high-risk medications such as antiepileptics, allopurinol, certain antibiotics, and NSAIDs ( -lactam antibiotics are among the most common culprit drugs for severe cutaneous adverse reactions (SCARs) ( Clinical implications This study provides an initial clinical characterization of concurrent DILI and SJS/TEN and proposes a hypothetical mechanism by which moxifloxacin may trigger mixed hepatic and cutaneous hypersensitivity reactions in the setting of prior PD-1 exposure

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Note on humans: These benefits are not established in humans , and no trial has tested the four-peptide combination [13]