Defining Regional Differences in Drug‐Induced Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis: A Tool to Improve Drug Safety?

Phillips, Elizabeth

doi:10.1002/cpt.1175

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…Genetic testing has a potential role among strategies used for prevention in identifying whether an individual may be susceptible to developing a serious adverse reaction from a particular drug, as pharmacogenomic studies have revealed strong associations between SCARs and genes encoding HLA molecules in a drug and ethnicity-specific pattern ( Su et al, 2016 ; Phillips, 2018 ; Kuruvilla et al, 2022 ). Thus, pharmacogenetic testing in SCARs has been proposed for prevention, monitoring, and diagnosis ( Pirmohamed, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

LTT and HLA testing as diagnostic tools in Spanish vancomycin-induced DRESS cases: A case-control study

Bellón

Lerma²,

Guijarro³

et al. 2022

Front. Pharmacol.

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe T-cell-mediated off-target adverse reaction. DRESS cases caused by vancomycin have often been reported. The HLA-A*32:01 allele has been associated with genetic susceptibility to vancomycin-induced DRESS in US citizens of European descent. We have analyzed the association of the HLA-A*32:01 allele in 14 Spanish DRESS cases in which vancomycin was suspected as the culprit drug, and the lymphocyte transformation test (LTT) as an in vitro assay to evaluate vancomycin sensitization. The results were compared to vancomycin-tolerant control donors. LTT was performed in 12 DRESS cases with PBMCs from resolution samples available and in a group of 12 tolerant donors. ROC curves determined that LTT is a suitable tool to identify patients sensitized to vancomycin (AUC = 0.9646; p < 0.0001). When a stimulation index >3 was regarded as a positive result, contingency tables determined 91% sensitivity, 91.67% specificity, 91% positive predictive value, and 91.67% negative predictive value (p = 0.0001, Fisher’s exact test). The HLA A*32:01 allele was determined by an allele-specific PCR assay in 14 cases and 25 tolerant controls. Among the DRESS cases, five carriers were identified (35.7%), while it was detected in only one (4%) of the tolerant donors, [odds ratio (OR) = 13.33; 95% CI: 1.364–130.3; p = 0.016]. The strength of the association increased when only cases with positive LTT to vancomycin were considered (OR = 24.0; 95% CI: 2.28–252.6; p = 4.0 × 10−3). Our results confirm the association of the risk allele HLA-A*32:01 with vancomycin-induced DRESS in Spanish cases, and support LTT as a reliable tool to determine vancomycin sensitization.

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Section: Discussionmentioning

confidence: 99%

LTT and HLA testing as diagnostic tools in Spanish vancomycin-induced DRESS cases: A case-control study

Bellón

Lerma²,

Guijarro³

et al. 2022

Front. Pharmacol.

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“…Differences in the structure of the drugs involved in the development of SJS and TEN in different regions of the world and ethnic groups may correlate with the established role of genetic factors in the occurrence of CADRs, as well as with the peculiarities of the prescription patterns of drugs in different countries and ethnic groups [ 61 , 62 , 63 , 64 ]. The geography of HLA-associated serious CADRS was shown to be dependent on the world distribution of the carriage rate of certain HLA alleles [ 65 , 66 ]. International Collaboration on SJS/TEN With Severe Ocular Complications indicated cold medicines, including NSAIDs, as the main group of drugs inducing studied pathology among Japanese patients.…”

Section: Discussionmentioning

confidence: 99%

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: Analysis of the Russian Database of Spontaneous Reports

Zyryanov,

Asetskaya,

Butranova

et al. 2024

Pharmaceuticals

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(1) Background: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are extremely severe cutaneous adverse drug reactions which are relatively rare in routine clinical practice. An analysis of a national pharmacovigilance database may be the most effective method of obtaining information on SJS and TEN. (2) Methods: Design—a retrospective descriptive pharmacoepidemiologic study of spontaneous reports (SRs) with data on SJS and TEN retrieved from the Russian National Pharmacovigilance database for the period from 1 April 2019 to 31 December 2023. Descriptive statistics was used to assess the demographic data of patients and the structure of suspected drugs. (3) Results: A total of 170 SRs on SJS and TEN were identified, of which 32.9% were SJS and 67.1%—TEN. In total, 30% were pediatric SRs, 21.2%—SRs of the elderly. There were 12 lethal cases, and all cases were TEN. The leading culprit drugs were anti-infectives for systemic use and nervous system agents. The top 10 involved drugs are as follows: lamotrigine (23.5%), ibuprofen (12.9%), ceftriaxone (8.8%), amoxicillin and amoxicillin with beta-lactam inhibitors (8.8%), paracetamol (7.6%), carbamazepine (5.9%), azithromycin (4.1%), valproic acid (4.1%), omeprazole (3.5%), and levetiracetam (3.5%). (4) Conclusions: Our study was the first study in Russia aimed at the assessment of the structure of the drugs involved in SJS and TEN on the national level.

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Role of Metabolism in Drug Toxicity

2020

Human Drug Metabolism

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Defining Regional Differences in Drug‐Induced Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis: A Tool to Improve Drug Safety?

Cited by 4 publications

References 11 publications

LTT and HLA testing as diagnostic tools in Spanish vancomycin-induced DRESS cases: A case-control study

LTT and HLA testing as diagnostic tools in Spanish vancomycin-induced DRESS cases: A case-control study

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: Analysis of the Russian Database of Spontaneous Reports

Role of Metabolism in Drug Toxicity

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