Abstract
Introduction: Chronic liver disease (CLD) affects 1.5 billion people globally, with drug-induced liver injury (DILI) representing a significant and underrecognized complication of prolonged immunosuppressive therapy, necessitating exploration of complementary therapeutic approaches.
Objective: To evaluate the efficacy of Ayurvedic intervention in drug-induced hepatotoxicity and assessment of hepatic fibrosis regression, biochemical stabilisation, and health-related quality of life improvement.
Methodology: A 58-year-old female with a 12-year history of Methotrexate and corticosteroid therapy for Rheumatoid Arthritis presented with fatigue, malaise, right hypochondriac pain, and abdominal distension. Baseline investigations including liver function tests, complete blood count, lipid profile, kidney function tests, ultrasonography, FibroScan, and Chronic Liver Disease Questionnaire (CLDQ) were conducted. Causality was established via RUCAM scoring. A structured three-month Ayurvedic treatment protocol alongside dietary and lifestyle modifications was instituted, followed by a two-month post-treatment follow-up.
Results: FibroScan values reduced from 22.4 kPa (F4) to 8.9 kPa (F2–F3), CLDQ scores improved from 6.23 to 30.4, haemoglobin improved significantly, follow-up ultrasonography demonstrated a stable liver, and all biochemical markers remained within normal limits, with no adverse effects observed.
Conclusion: Ayurvedic intervention demonstrated clinical efficacy in managing drug-induced hepatotoxicity, achieving fibrosis regression and meaningful quality of life improvement, underscoring the value of integrative healthcare in complex chronic liver conditions.

Key words: Ayurveda, Chronic Liver Disease, Chronic Liver Disease Questionnaire (CLDQ), Drug-Induced Liver Injury, FibroScan, Fibrosis Regression, Integrative Medicine.