FDA Qualifies GLDH Biomarker
CDER has qualified glutamate dehydrogenase (GLDH) as a safety biomarker to detect possible drug-induced liver injury in conjunction with alanine aminotransferase (ALT) and other standard liver injury markers in clinical trials, particularly in participants with elevated transaminases due to muscle injury. An agency notice says innovation in biomarker development for drug safety monitoring is needed, particularly for patients with muscle disorders, where traditional liver injury markers can be confounded by muscle damage.
GLDH is said to be a more liver-specific enzyme that was validated as capable of detecting hepatocellular injury. Unlike ALT, which is released from both liver and muscle tissue, FDA says, GLDH is primarily expressed in the liver and remains unaffected by muscle injury or degeneration. The notice says the liver specificity “enables better detection of possible hepatocellular drug-induced liver injury in populations where muscle damage could otherwise confound such liver safety assessment.”