title: HLA-B*5801: utility and cost-effectiveness in the Asia-Pacific Region.
abstract: Gout is a common condition which is mainly treated with the hypo-uricemic agent, allopurinol. Although allopurinol is generally a well-tolerated drug, there is a small risk of developing potentially fatal complications, such as allopurinol hypersensitivity syndrome. Recent advances in pharmacogenomics have made possible the identification of genes which confer susceptibility to specific drugs. A recent multi-national case-control study has reported allopurinol as the most common drug associated with Stevens-Johnson syndrome and toxic epidermal necrolysis. Several studies have established a strong association between the human leukocyte antigen (HLA)-B*5801 gene and development of Stevens-Johnson syndrome and toxic epidermal necrolysis. The allele frequency of HLA-B*5801 is highest in the South East Asian population.Since other hypo-uricemic agents are available, patients may wish to have HLA-B*5801 testing before being started on allopurinol. As the test for HLA-B*5801 is expensive, time-consuming and only available in selected laboratories, there is a need to evaluate the utility and cost-effectiveness of this test in our region.
authors: Division of Rheumatology and Clinical Immunology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China. ingyeo@hotmail.com
authors: Siaw Ing
authors: SI
authors: Yeo
mesh_terms: D000493:Allopurinol / Q000009:adverse effects*; D001208:Asia; D044362:Australasia; D003362:Cost-Benefit Analysis; D063926:Drug Hypersensitivity Syndrome / Q000235:genetics* / Q000276:immunology / Q000517:prevention & control; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing / Q000191:economics*; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000009:adverse effects*; D015235:HLA-B Antigens / Q000235:genetics*; D017048:Health Care Costs; D006801:Humans; D018579:Patient Selection; D010597:Pharmacogenetics / Q000191:economics*; D010641:Phenotype; D011237:Predictive Value of Tests; D012307:Risk Factors; D013262:Stevens-Johnson Syndrome / Q000235:genetics* / Q000276:immunology / Q000517:prevention & control
chemical_list: D006074:Gout Suppressants; D015235:HLA-B Antigens; C500126:HLA-B*58:01 antigen; D000493:Allopurinol
keywords: HLA‐B*5801; Stevens‐Johnson syndrome; allopurinol hypersensitivity syndrome; severe cutaneous adverse reactions; toxic epidermal necrolysis