title: Levetiracetam-induced cutaneous adverse drug reactions were not associated with HLA genes in a small sample of Chinese patients with epilepsy.
abstract: This study aimed to evaluate the clinical characteristics of levetiracetam (LEV)-induced cutaneous adverse drug reactions (cADRs) and to explore its possible genetic association with the human leukocyte antigen (HLA) genes.
  
  
  
  Nine cases with LEV-induced cADRs were recruited. Demographic and clinical information of these cases was summarized. Additionally, cases were matched with LEV-tolerant controls (1:4). High-resolution HLA class I and class II genotyping was performed for each participant. The allele frequencies between the cases and controls were compared.
  
  
  
  All LEV-induced cADRs were mild skin rashes which occurred within 28 days of LEV exposure. The mean latency from LEV exposure to skin rash was (15.67±5.41) days (ranging 6-27). The carrier rates of the two alleles, HLA-DRB1*0405 and HLA-DQB1*0401, were higher in cases compared with controls (the same P=0.036, OR=13.875, 95% CI: 1.273-151.230). The association between the HLA-C*0304 allele and LEV-induced cADRs was boundary (P=0.05, OR=5.2, 95% CI: 1.086-24.897). However, the above-mentioned HLA alleles didn't reach statistical significance after multiple comparisons.
  
  
  
  Safety monitoring was necessary within four weeks after the initiation of LEV treatment, although it has been regarded as a safe antiepileptic drug. Our study failed to show any potential link between HLA alleles and LEV-induced cADRs in Han Chinese. Further studies are needed to clarify the genetic and immunological mechanisms of LEV-induced cADRs.
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Fa-Yun
authors.initials: FY
authors.lastname: Hu
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Jie-Chuan
authors.initials: JC
authors.lastname: Ren
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: An
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Jia-Ni
authors.initials: JN
authors.lastname: Chen
authors.affiliation: Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. Electronic address: zhoudong66@yahoo.de.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D044466:Asian People; D002648:Child; D002681:China; D004827:Epilepsy / Q000188:drug therapy* / Q000235:genetics; D005076:Exanthema / Q000139:chemically induced* / Q000235:genetics*; D005260:Female; D005787:Gene Frequency; D060005:Genotyping Techniques; D006680:HLA Antigens / Q000235:genetics*; D006579:Heterozygote; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D008875:Middle Aged; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D006680:HLA Antigens; D000077287:Levetiracetam; D010889:Piracetam
keywords: Cutaneous adverse drug reactions; Epilepsy; Human leukocyte antigen; Levetiracetam; Rash