Association between the HLA-B alleles and carbamazepine-induced SJS/TEN: A meta-analysis

Wang, Qianyu; Sun, Shusen; Xie, Meng; Zhao, Kun; Li, Xingang; Zhao, Zhigang

doi:10.1016/j.eplepsyres.2017.05.015

Cited by 45 publications

(39 citation statements)

References 33 publications

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“…In contrast to our finding, Cheung et al noted in Han Chinese that the presence of the HLA-B ∗ 58:01 allele appears to be protective against the development of carbamazepine-induced SJS/TEN [ 30 ]. A meta-analysis investigating the association of HLA-B alleles and carbamazepine-induced SJS/TEN also found that the HLA-B ∗ 58:01 allele was a protective marker among Asian populations [ 31 ]. From these observations, we can conclude that genetic susceptibility to carbamazepine-induced cADRs is phenotype-specific.…”

Section: Discussionmentioning

confidence: 99%

Association between HLA-B Alleles and Carbamazepine-Induced Maculopapular Exanthema and Severe Cutaneous Reactions in Thai Patients

Sukasem

Chaichan

Nakkrut

et al. 2018

Journal of Immunology Research

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The HLA-B∗15:02 allele has been reported to have a strong association with carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in Thai patients. The HLA-B alleles associated with carbamazepine-induced maculopapular exanthema (MPE) and the drug reaction with eosinophilia and systemic symptoms (DRESS) among the Thai population have never been reported. The aim of the present study was to carry out an analysis of the involvement of HLA-B alleles in carbamazepine-induced cutaneous adverse drug reactions (cADRs) in the Thai population. A case-control study was performed by genotyping the HLA-B alleles of Thai carbamazepine-induced hypersensitivity reaction patients (17 MPE, 16 SJS/TEN, and 5 DRESS) and 271 carbamazepine-tolerant controls. We also recruited 470 healthy Thai candidate subjects who had not taken carbamazepine. HLA-B∗15:02 showed a significant association with carbamazepine-induced MPE (P = 0.0022, odds ratio (OR) (95% confidence interval [CI]) = 7.27 (2.04–25.97)) and carbamazepine-induced SJS/TEN (P = 4.46 × 10−13; OR (95% CI) = 70.91(19.67–255.65)) when compared with carbamazepine-tolerant controls. Carbamazepine-induced SJS/TEN also showed an association with HLA-B∗15:21 allele (P = 0.013; OR (95% CI) = 9.54 (1.61–56.57)) when compared with carbamazepine-tolerant controls. HLA-B∗58:01 allele was significantly related to carbamazepine-induced MPE (P = 0.007; OR (95% CI) = 4.73 (1.53–14.66)) and DRESS (P = 0.0315; OR (95% CI) = 7.55 (1.20–47.58)) when compared with carbamazepine-tolerant controls. These alleles may serve as markers to predict carbamazepine-induced cADRs in the Thai population.

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Section: Discussionmentioning

confidence: 99%

Association between HLA-B Alleles and Carbamazepine-Induced Maculopapular Exanthema and Severe Cutaneous Reactions in Thai Patients

Sukasem

Chaichan

Nakkrut

et al. 2018

Journal of Immunology Research

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“…Thus, the development of SJS/TEN is also considered an allergic or autoimmune side effect involving HLA. 33 The Kyoto Encyclopedia of Genes and Genomes (KEGG) database also showed that carbamazepine, fosphenytoin, and phenytoin were related to HLA-B*1502, and signals were detected for these drugs. HLA-B*1502 occurs mainly in Asian patients and is the major population in this study.…”

Section: Discussionmentioning

confidence: 99%

Antiepileptic combination therapy with Stevens‐Johnson syndrome and toxic epidermal necrolysis: Analysis of a Japanese pharmacovigilance database

et al. 2020

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Objective: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-mediated diseases characterized by an extensive loss of the epidermal skin layer, often resulting in death. SJS and TEN are often triggered by certain drugs, including antiepileptic drugs (AEDs). Epilepsy is very difficult to treat and often involves the combination of two or more AEDs. In this study, we quantified not only the risk of SJS or TEN associated with single-AED therapy but also the risk related to concomitant AED treatment using reporting-derived signals. Methods: An analysis of the Japanese Adverse Drug Event Report (JADER) database was performed from the first quarter of 2004 to the fourth quarter of 2018. The single-AED signals were evaluated using the proportional reporting ratio (PRR), and the combination therapy signals were evaluated using Ω shrinkage measure and combination risk ratio (CRR). Results: SJS signals were associated with 11 AEDs, and TEN signals were related to 12 AEDs. Moreover, the following AED combinations were associated with SJS signals: carbamazepine-lorazepam (Ω 025 : 0.33, CRR: 2.18) and fosphenytoin-lorazepam (Ω 025 : 0.99, CRR: 39.20). The TEN signals were related to the following combi

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“…Several recent studies have shown that allergic reactions caused by carbamazepine are associated with HLA gene polymorphisms. [15][16][17][18] HLA-B*1502 is an HLA allele that is found almost exclusively in Asian populations, including Chinese Han, Filipinos, Malaysians, South Asian Indians, and Thais, and it is estimated that at least 10% to 15% of epilepsy patients carry the HLA-B*1502 genotype. 19 Allergic skin reactions include mild MPE, 20 HSS, 21 SJS, and TEN.…”

Section: Discussionmentioning

confidence: 99%

HLA-B*1502 is associated with aromatic anticonvulsant drug-induced cutaneous adverse drug reactions among the Hakka population in China

et al. 2020

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Association between the HLA-B alleles and carbamazepine-induced SJS/TEN: A meta-analysis

Cited by 45 publications

References 33 publications

Association between HLA-B Alleles and Carbamazepine-Induced Maculopapular Exanthema and Severe Cutaneous Reactions in Thai Patients

Association between HLA-B Alleles and Carbamazepine-Induced Maculopapular Exanthema and Severe Cutaneous Reactions in Thai Patients

Antiepileptic combination therapy with Stevens‐Johnson syndrome and toxic epidermal necrolysis: Analysis of a Japanese pharmacovigilance database

HLA-B*1502 is associated with aromatic anticonvulsant drug-induced cutaneous adverse drug reactions among the Hakka population in China

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