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HLA Genotype and Carbamazepine-Induced Cutaneous Adverse Drug Reactions: A Systematic Review

Yip, V L ; Marson, A G ; Jorgensen, A L ; Pirmohamed, M ; Alfirevic, A

Clinical pharmacology and therapeutics, 2012-12, Vol.92 (6), p.757-765 [Periódico revisado por pares]

Basingstoke: Blackwell Publishing Ltd

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Título:
HLA Genotype and Carbamazepine-Induced Cutaneous Adverse Drug Reactions: A Systematic Review
Autor: Yip, V L ; Marson, A G ; Jorgensen, A L ; Pirmohamed, M ; Alfirevic, A
Assuntos: Alleles ; Anticonvulsants - adverse effects ; Asians ; Biological and medical sciences ; Carbamazepine - adverse effects ; Case-Control Studies ; Confidence Intervals ; Drug Eruptions - genetics ; Drug Hypersensitivity - genetics ; Genotype ; HLA Antigens - genetics ; HLA-A Antigens - genetics ; HLA-B Antigens - genetics ; Humans ; Medical sciences ; Odds Ratio ; Pharmacology. Drug treatments ; Predictive Value of Tests
É parte de: Clinical pharmacology and therapeutics, 2012-12, Vol.92 (6), p.757-765
Notas: Supplementary Figure S1
istex:1A9DA17599921D6C02B5F229E449359776508A93
ArticleID:CPTCLPT2012189
ark:/67375/WNG-QSF5R1MF-R
Descrição: Carbamazepine (CBZ) therapy is associated with cutaneous adverse reactions in up to 10% of patients. Predisposition to these hypersensitivity reactions has been linked to the human leukocyte antigen (HLA) genotype. This systematic review determines the strength of these associations and accuracy of proposed genetic screening. We determined that carriage of HLA‐B*1502 in Asian patients was associated with a pooled odds ratio (OR) of 113.4 (95% confidence interval (CI) = 51.2–251.0, P < 1 × 10−5) for CBZ‐induced Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). A total of 461 patients would need to be screened for HLA‐B*1502 to prevent one episode of SJS/TEN. HLA‐A*3101 is significantly associated with all phenotypes of CBZ hypersensitivity in multiple ethnicities with a pooled OR of 9.5 (95% CI = 6.4–13.9, P < 1 × 10−5). Between 47 and 67 patients would need to be tested for HLA‐A*3101 to prevent one episode of hypersensitivity. Our findings suggest that HLA testing before carbamazepine therapy would be effective at identifying individuals at risk of hypersensitivity and applicable to multiple populations providing hope for prevention in the future. Clinical Pharmacology & Therapeutics (2012); 92 6, 757–765. doi:10.1038/clpt.2012.189
Editor: Basingstoke: Blackwell Publishing Ltd
Idioma: Inglês

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HLA Genotype and Carbamazepine-Induced Cutaneous Adverse Drug Reactions: A Systematic Review

Yip, V L ; Marson, A G ; Jorgensen, A L ; Pirmohamed, M ; Alfirevic, A

Basingstoke: Blackwell Publishing Ltd

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