Common Risk Allele in Aromatic Antiepileptic-Drug Induced Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis in Han Chinese

Hung, Shuen‐Iu; Chung, Wen‐Hung; Zs, Liu; Chen, Chien-Hsiun; Hsih, Mo-Song; Hui, Rosaline Chung‐Yee; Chu, Chia‐Yu; Chen, Yuan-Tsong

doi:10.2217/pgs.09.162

Cited by 272 publications

(216 citation statements)

References 33 publications

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“…28 These results indicate that aromatic anticonvulsants share a common risk allele, HLA-B*1502, presumably by similar antigen recognition, although the association is highest with carbamazepine. Other genetic factors may also contribute to the pathomechanism of the disease.…”

Section: Hla-b Association In Other Aromatic Amine Anticonvulsant-indmentioning

confidence: 84%

Pharmacogenetics of cutaneous adverse drug reactions

Aihara

2011

The Journal of Dermatology

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Drug-induced hypersensitivity reactions are of major medical concern because they are associated with high morbidity and high mortality. In addition, individual patients' reactions are impossible to predict in each patient. In the field of severe cutaneous adverse drug reactions (cutaneous ADR) such as Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug-induced hypersensitivity syndrome (DHIS) or drug rash with eosinophilia and systemic symptoms (DRESS), major advances have recently been gained through studies of an association between HLA alleles and drug hypersensitivity induced by specific drugs. The results of these pharmacogenomic studies allow prediction of the risk of adverse reactions in patients treated with certain drugs, including carbamazepine and other aromatic antiepileptic drugs, allopurinol and abacavir. However, different ethnic populations show variations in the genetic associations. A strong association between carbamazepine-induced SJS ⁄ TEN and HLA-B*1502 has been found in Southeast Asian patients but not in Caucasian and Japanese patients. Moderate associations between aromatic amine anticonvulsants and other HLA alleles have been proposed in Japanese patients. In contrast, HLA-B*5801 was found to be associated with allopurinol-induced cutaneous ADR, including SJS ⁄ TEN and DIHS ⁄ DRESS, in Caucasian and Asian patients, including the Japanese. These differences may, at least in part, be due to the differences in allele frequency in different ethnic populations. This article reviews the progress in pharmacogenomics, associated mainly with carbamazepine and allopurinol in different ethnic populations. Pharmacogenetic screening based on associations between adverse reactions and specific HLA alleles helps to avoid serious conditions associated with drug hypersensitivity.

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Section: Hla-b Association In Other Aromatic Amine Anticonvulsant-indmentioning

confidence: 84%

Pharmacogenetics of cutaneous adverse drug reactions

Aihara

2011

The Journal of Dermatology

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“…49 Similar findings emerged from other Han Chinese populations. [68][69][70][71] A significant association between CBZ-SJS/TEN and HLA-B*1502 was also found in Thai, 72,73 Malay 74 and, to a lesser degree, Indian patients. 75 In a European study, the only HLA-B*1502-positive CBZ-SJS patients were of East Asian descent.…”

Section: Discussionmentioning

confidence: 79%

“…80 HLA-B*1502 was a risk factor for ox-CBZ-induced mild maculopapular eruptions, 81 ox-CBZ-SJS/TEN and PHY-SJS/TEN. 68 PHY-HSR was further associated with of HLA-B*1301, Cw*0801 and HLA-DRB1*1602 in a Chinese population. 68 The high incidence of HLA-B*1502 among Asian individuals (10-15%) correlates with a high incidence of SJS/TEN in this population (17 to 25 in every 10000 individuals in Taiwan and Thailand), compared to its low incidence among Caucasians (1% to 2%), which correlates with a low incidence in this population (1 to 6 in every 10000 individuals).…”

Section: Discussionmentioning

confidence: 84%

“…68 The high incidence of HLA-B*1502 among Asian individuals (10-15%) correlates with a high incidence of SJS/TEN in this population (17 to 25 in every 10000 individuals in Taiwan and Thailand), compared to its low incidence among Caucasians (1% to 2%), which correlates with a low incidence in this population (1 to 6 in every 10000 individuals). 49,50,82 No association was found between LTG-SJS/TEN and HLA-B*1502 in Chinese, 68 or European patients. 58 In our study, we observed that negative HLA-B*1502 does not predict negative LTG-HSR.…”

Section: Discussionmentioning

confidence: 86%

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Genetic and immune predictors for hypersensitivity syndrome to antiepileptic drugs

Neuman

Cohen

Nanau

et al. 2012

Translational Research

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“…Fifteen years since the sequencing of the human genome, genomic medicine has yet to live up to the expectations promised. Despite some initial successes, [5][6][7][8][9][10][11][12][13][14][15][16] very few pharmacogenomics tests are actually integrated routinely in clinics, and the translation of pharmacogenomics to standard clinical practices worldwide is often slow or non-existent.…”

Section: Introductionmentioning

confidence: 99%

Role of pharmacogenetics in public health and clinical health care: a SWOT analysis

2016

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Pharmacogenomics has been lauded as an important innovation in clinical medicine as a result of advances in genomic science. As one of the cornerstones in precision medicine, the vision to determine the right medication in the right dosage for the right treatment with the use of genetic information has not exactly materialised, and few genetic tests have been implemented as the standard of care in health systems worldwide. Here we review the findings from a SWOT analysis to examine the strengths, weaknesses, opportunities and threats around the role of pharmacogenetics in public health and clinical health care, at the micro, meso and macro levels corresponding to the perspectives of the individuals (scientists, patients and physicians), the health-care institutions and the health systems, respectively.

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Common Risk Allele in Aromatic Antiepileptic-Drug Induced Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis in Han Chinese

Cited by 272 publications

References 33 publications

Pharmacogenetics of cutaneous adverse drug reactions

Pharmacogenetics of cutaneous adverse drug reactions

Genetic and immune predictors for hypersensitivity syndrome to antiepileptic drugs

Role of pharmacogenetics in public health and clinical health care: a SWOT analysis

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