Association between HLA-B*1502 allele and antiepileptic drug-induced cutaneous reactions in Han Chinese.
A previous study conducted in Taiwan found a 100% association between HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome (SJS) in Han Chinese subjects, with an extremely high odds ratio compared with carbamazepine-tolerant subjects (odds ratio = 2,504). We examined this association in 24 Hong Kong Han Chinese subjects who had cutaneous adverse reactions induced by different antiepileptic drugs (AEDs). They were matched with 48 AED-tolerant controls. HLA-B*1502 was associated with severe cutaneous reactions (SCR) induced by AEDs, which included carbamazepine, phenytoin, and lamotrigine (p = 0.001, odds ratio = 17.6), but was not associated with maculopapular exanthema (MPE) (p = 0.32). Further studies in larger samples of ethnically matched subjects should be conducted to confirm the findings. Identification of genetic polymorphisms predisposing to development of AED-induced SCR offers the possibility of avoiding these high-risk drugs in genetically susceptible individuals.
Man
Celeste B L
CB
Division of Neurology, Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Kwan
Patrick
P
Baum
Larry
L
Yu
Evelyn
E
Lau
K M
KM
Cheng
Alice S H
AS
Ng
Margaret H L
MH
D000293:Adolescent; D000328:Adult; D000483:Alleles; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D044466:Asian People / Q000235:genetics*; D002220:Carbamazepine / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D003875:Drug Eruptions / Q000208:ethnology* / Q000209:etiology* / Q000235:genetics; D004342:Drug Hypersensitivity / Q000208:ethnology / Q000235:genetics; D004827:Epilepsy / Q000188:drug therapy* / Q000208:ethnology / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease / Q000208:ethnology; D015235:HLA-B Antigens / Q000235:genetics*; D059910:HLA-B15 Antigen; D006723:Hong Kong; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D010597:Pharmacogenetics; D010672:Phenytoin / Q000009:adverse effects / Q000627:therapeutic use; D011110:Polymorphism, Genetic; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced / Q000208:ethnology / Q000235:genetics; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D015235:HLA-B Antigens; C483536:HLA-B*15:02 antigen; D059910:HLA-B15 Antigen; D014227:Triazines; D002220:Carbamazepine; D010672:Phenytoin; D000077213:Lamotrigine