Table 2.

Summary of Cases of Selective Androgen Receptor Modulator (SARM)-Associated Hepatotoxicity

Study	SARM	Presenting Symptoms	Duration of SARM Use	Initial / Peak Bilirubin, mg/dL	Time to Peak Bilirubin After SARM Cessation	Initial ALT / AST / ALP, IU/L	Initial Platelet Count, × 10⁹/L	INR	Liver Histology	Management
Flores et al, 2020⁹	Ligandrol	Jaundice, anorexia, nausea, lethargy, weight loss	9 weeks	6.78/6.78	5 weeks	273/111/289	387	1	–	SARM cessation, supportive care
Barbara et al, 2020¹⁰	Ligandrol	Jaundice, fatigue, pruritus, weight loss	2 weeks	35/38.2	–	229/91/88	–	1.1	Cholestatic hepatitis with mild portal, periportal, and perisinusoidal fibrosis	SARM cessation, supportive care
Bedi et al, 2021¹²	Enobosarm	Jaundice, anorexia, weight loss, lethargy, diarrhea	2 months	19.9/43.0	–	112/69/268	313	1.3	Moderate to severe cholestasis, very mild ductal damage	SARM cessation, supportive care
Flores et al, 2020⁹	RAD-140	Jaundice, pruritus	4 weeks and intermittent use thereafter	17/20.2	–	44/61/286	347	1.2	Moderate cholestasis, ductopenia, minimal fibrosis and inflammation	SARM cessation, supportive care
Barbara et al, 2020,¹¹	RAD-140 / Ligandrol	Jaundice, right upper quadrant pain, pruritus, diarrhea	7 weeks	34.5/34.5	–	46/36/529	–	1.0	Diffuse canalicular cholestasis, ductal reaction, mild lobular inflammation with rare non-necrotizing epithelioid granuloma and mild portal and periportal fibrosis	SARM cessation, supportive care
Present case, 2022	RAD-140	Jaundice, abdominal pain, scleral icterus, pruritus	5 weeks	1.2/38.5	5 weeks, 6 days	313/182/103	180	0.8	Moderate intracytoplasmic and canalicular cholestasis, minimal portal inflammation	SARM cessation, supportive care

ALP, alkaline phosphatase; ALT, alanine transaminase; AST, aspartate aminotransferase; INR, international normalized ratio.