title: Clinical application of pharmacogenomics: the example of HLA-based drug-induced toxicity.
abstract: Pharmacogenomics is gradually becoming more and more indispensable in modern medicine. In several cases, a pharmacogenomics test may alleviate serious drug-induced adverse reactions, if it precedes drug prescription. In this article, we provide an overview of the well-established HLA-based carbamazepine- and allopurinol-induced adverse reactions, as one of the most characteristic examples of the clinical application of pharmacogenomics, highlighting its regional impact in Southeast Asian populations in preventing adverse reactions of certain drug/allele pairs. This example provides useful insights towards evidence generation for policy implementation, including economic evaluation analysis, the implementation of pharmacogenomics testing procedures and monitoring of policy effectiveness, hence serving, per se or in the context of international collaborative efforts, as a model for similar cases in several national healthcare systems worldwide.
authors.affiliation: Laboratory for International Alliance on Genomic Research, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
authors.forename: Ming Ta Michael
authors.initials: MT
authors.lastname: Lee
authors.forename: Surakameth
authors.initials: S
authors.lastname: Mahasirimongkol
authors.forename: Yanfei
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wimon
authors.initials: W
authors.lastname: Suwankesawong
authors.forename: Usa
authors.initials: U
authors.lastname: Chaikledkaew
authors.forename: Cristiana
authors.initials: C
authors.lastname: Pavlidis
authors.forename: George P
authors.initials: GP
authors.lastname: Patrinos
authors.forename: Wasun
authors.initials: W
authors.lastname: Chantratita
mesh_terms: D056150:Acute Generalized Exanthematous Pustulosis / Q000235:genetics / Q000276:immunology; D000483:Alleles; D000493:Allopurinol / Q000009:adverse effects*; D000927:Anticonvulsants / Q000009:adverse effects*; D000963:Antimetabolites / Q000009:adverse effects*; D044466:Asian People / Q000235:genetics; D002220:Carbamazepine / Q000009:adverse effects*; D063926:Drug Hypersensitivity Syndrome / Q000235:genetics / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D000949:Histocompatibility Antigens Class II / Q000235:genetics*; D006801:Humans; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D013262:Stevens-Johnson Syndrome / Q000235:genetics / Q000276:immunology
chemical_list: D000927:Anticonvulsants; D000963:Antimetabolites; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D002220:Carbamazepine; D000493:Allopurinol