Association between HLA-A*3201 allele and oxcarbazepine-induced cutaneous adverse reactions in Eastern Han Chinese population

Xu, Jianyang; Shi, Xiangsong; Qiu, Yinghui; Zhang, Yadong; Chen, Shengdi; Shi, Yi‐Wu; Deng, Yulei

doi:10.1016/j.seizure.2018.12.011

Cited by 7 publications

(2 citation statements)

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“…A total of 152 published studies, and two unpublished data provided by the corresponding author ( Supplementary Tables S3, S4 ) were collected. After exclusion, ten studies relevant to the association between HLA-A*24:02 and AED-MPE met the inclusion criteria, comprising of 488 cases with AED-MPE and 1277 AED-tolerant controls ( Wang et al, 2010 ; Fricke-Galindo et al, 2014 ; Hsiao et al, 2014 ; Moon et al, 2015 ; Chen et al, 2017 ; Koomdee et al, 2017 ; Wang et al, 2019 ; Xu et al, 2019 ; Supplementary Table S4 ). The association between HLA-A*24:02 and AED-MPE was verified across different populations of China, Korea, Malaysia, Mexican and Thai (134/488 vs. 321/1277, p = 0.02, Figure 1A ).…”

Section: Resultsmentioning

confidence: 99%

HLA Risk Alleles in Aromatic Antiepileptic Drug-Induced Maculopapular Exanthema

et al. 2021

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To characterize human leukocyte antigen (HLA) loci as risk factors in aromatic antiepileptic drug-induced maculopapular exanthema (AED-MPE). A case-control study was performed to investigate HLA loci involved in AED-MPE in a southern Han Chinese population. Between January 2007 and June 2019, 267 patients with carbamazepine (CBZ), oxcarbazepine (OXC), or lamotrigine (LTG) associated MPE and 387 matched drug-tolerant controls from six centers were enrolled. HLA-A/B/C/DRB1 genotypes were determined using sequence-based typing. Potential risk alleles were validated by meta-analysis using data from different populations and in silico analysis of protein-drug interactions. HLA-DRB1*04:06 was significantly associated with OXC-MPE (p = 0.002, pc = 0.04). HLA-B*38:02 was associated with CBZ-MPE (p = 0.03). When pooled, HLA-A*24:02, HLA-A*30:01, and HLA-B*35:01 additionally revealed significant association with AED-MPE. Logistic regression analysis showed a multiplicative interaction between HLA-A*24:02 and HLA-B*38:02 in CBZ-MPE. Meta-analysis of data from different populations revealed that HLA-24*:02 and HLA-A*30:01 were associated with AED-MPE (p = 0.02 and p = 0.04, respectively). In silico analysis of protein-drug interaction demonstrated that HLA-A*24:02 and HLA-A*30:01 had higher affinities with the three aromatic AEDs than the risk-free HLA-A allele. HLA-DRB1*04:06 showed relatively specific high affinity with S-monohydroxy derivative of OXC. HLA-DRB1*04:06 is a specific risk allele for OXC-induced MPE in the Southern Han Chinese. HLA-A*24:02, possibly HLA-A*30:01, are common risk factors for AED-MPE. The multiplicative risk potential between HLA-A*24:02 and HLA-B*38:02 suggests that patients with two risk alleles are at greater risk than those with one risk allele. Inclusion of these HLA alleles in pre-treatment screening would help estimating the risk of AED-MPE.

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Section: Resultsmentioning

confidence: 99%

HLA Risk Alleles in Aromatic Antiepileptic Drug-Induced Maculopapular Exanthema

et al. 2021

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“…[2][3][4] Rare cutaneous reactions include maculopapular eruption, Stevens-Johnson syndrome, and toxic epidermal necrolysis, which require discontinuation. 5 Oxcarbazepine was cited as an effective treatment for treatment-resistant focal epilepsy in adults. 6 Oxcarbazepine is also used off label as a psychotropic medication in adults [7][8][9][10][11][12][13] and for treatment of epilepsy in children and adolescents.…”

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Utility of oxcarbazepine in the treatment of childhood and adolescent psychiatric symptoms

Morrow

Young

Spencer

et al. 2020

Baylor University Medical Center Proceedings

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The primary aims of this study were to determine if oxcarbazepine is a safely tolerated option for treatment of psychiatric symptoms in children and whether its use facilitates dose modification of other psychotropic medications. A retrospective chart review was completed using data extracted from the electronic medical record of a large outpatient child psychiatry clinic. A total of 507 of 740 children prescribed oxcarbazepine for psychiatric indications for 3 months or more had adequate data to assess clinical responses and medication outcomes. Most patients prescribed oxcarbazepine experienced clinically significant control of irritability/anger, mood stabilization, aggressive outbursts, impulsivity, or anxiety, with over 80% achieving at least maintenance symptom control. In all, 51% and 25% fully discontinued second-or third-generation antipsychotic or antidepressant medication, respectively, after starting oxcarbazepine; 8% discontinued oxcarbazepine for nonresponse, while 9% stopped oxcarbazepine because of emergent side effects. In patients fully discontinuing or reducing the second-or third-generation antipsychotic dose by 50% or more, improvements in body mass index were observed. Oxcarbazepine may prove to be an appropriate alternative to antipsychotic and antidepressant medications for treating psychiatric symptoms in children and adolescents. In particular, it may be a more metabolically neutral psychotropic medication.

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Oxcarbazepine

2019

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Association between HLA-A*3201 allele and oxcarbazepine-induced cutaneous adverse reactions in Eastern Han Chinese population

Cited by 7 publications

References 58 publications

HLA Risk Alleles in Aromatic Antiepileptic Drug-Induced Maculopapular Exanthema

HLA Risk Alleles in Aromatic Antiepileptic Drug-Induced Maculopapular Exanthema

Utility of oxcarbazepine in the treatment of childhood and adolescent psychiatric symptoms

Oxcarbazepine

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