Diagnostic utility of human leukocyte antigen B*15:02 screening in severe carbamazepine hypersensitivity syndrome

Moutaouakkil, Youssef; Adouani, Badr; Cherrah, Yahia; Lamsaouri, Jamal; Bousliman, Yassir

doi:10.4103/aian.aian_492_18

Cited by 7 publications

(7 citation statements)

References 48 publications

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“…Combining this result with previous studies, 100 the authors suggest that screening two alleles, HLA‐B*57:01 and HLA‐A*31:01, could reduce CBZ‐induced‐SCAR in Europeans 99 . HLA‐B*15:02 has also been strongly associated with CBZ‐induced‐SJS/TEN in other ethnic groups such as Han Chinese, Thai, and Malaysian populations 101 . These results suggest that screening this allele in populations with high allele frequency could prevent the occurrence of CBZ‐induced‐SJS/TEN 101 …”

Section: Genetic Susceptibilitysupporting

confidence: 71%

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Advances and novel developments in drug hypersensitivity diagnosis

Ariza

Mayorga

Bogas

et al. 2020

Allergy

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The diagnosis of drug hypersensitivity reactions (DHRs) has important implications for both patients and health system. 1 Mainly because an allergy label, whether true or not, implies the avoidance of medications that may be essential, the performance of unnecessary desensitization procedures, or the use of alternative medications. All these alternatives can lead to a less effective treatment, more potential adverse effects, and costs for health systems. 2 Moreover, in the case of antibiotics, it results in bacterial resistance. 3 Considering that there are no specific tests to distinguish between a viral infection and DHRs in the acute phase, a diagnostic work-up should be performed to remove a false label of hypersensitivity. 4 DHRs diagnosis is complex, time consuming, needs to be done by trained staff, and it is not standardized for many drugs. It is mainly based on skin testing (ST) and drug provocation tests (DPTs),

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Section: Genetic Susceptibilitysupporting

confidence: 71%

“…HLA‐B*15:02 has also been strongly associated with CBZ‐induced‐SJS/TEN in other ethnic groups such as Han Chinese, Thai, and Malaysian populations 101 . These results suggest that screening this allele in populations with high allele frequency could prevent the occurrence of CBZ‐induced‐SJS/TEN 101 …”

Section: Genetic Susceptibilitymentioning

confidence: 90%

Advances and novel developments in drug hypersensitivity diagnosis

Ariza

Mayorga

Bogas

et al. 2020

Allergy

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“…Regarding global populations, Southeast Asians are regarded as having the highest frequency of HLA-B*15:02 in the world ( Moutaouakkil et al, 2019 ; Van Nguyen et al, 2019 ). Indeed, numerous studies published the frequency of HLA-B*15:02 in their own country, such as 15.11% in Thailand ( Zhang et al, 2011 ), 32.8% in Indonesia ( Khosama, 2017 ), 8.3% in Malaysia ( Chang et al, 2011 ), and 5.7% in Singapore ( Middleton et al, 2004 ).…”

Section: Discussionmentioning

confidence: 99%

“…In Caucasians, Japanese, and Koreans, even though a myriad of meticulous research has been conducted about HLA-B*1502 , this allele is reported to be rare and not associated with statistically significant risk in these populations. In contrast, the HLA-B*15:02 allele was believed to have the highest allele frequency and fatal risk in the general population of Southeast Asia ( Moutaouakkil et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

The pharmacogenomics of carbamazepine-induced cutaneous adverse drug reaction in the South of Vietnam

et al. 2023

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Background: The relationship between HLA-B*15:02 and Severe Cutaneous Adverse Reactions was rigorously examined in Japanese, Han Chinese, Thais, and Caucasians. However, the number of studies about this topic in Vietnamese population is still limited and mostly focuses on the North of Vietnam.Objective: This study aims to clarify the genetic culprit of SCARs in Vietnamese population, particularly in the South of Vietnam, and to validate our result by a meta-analysis about this topic in Vietnamese.Method: A retrospective case-control study with 37 patients treated with carbamazepine monotherapy. Statistical calculation and meta-analysis were performed by R software.Result:HLA-B*15:02 increases the risk of SJS 12.5 times higher in CBZ-treated patients (p-value = 0.017). However, this allele has no impact on MCARs (Mild Cutaneous Adverse Reactions) of CBZ. The number needed to test and the number needed to genotype is two and nine patients respectively.Conclusion: This study recommends more investigations about the cost-effectiveness of this test to accelerate the protection of Southern Vietnamese from SCARs.

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“…Each antiepileptic was analyzed separately. For Carbamazepine, there were 42 case-control studies(11-14)(15-52)and 7 meta analyses (39,(53)(54)(55)(56)(57)(58). For Lamotrigine, there were 30 case-control studies (13,15,17,26,34,39,42,46,49,(59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72) and 3 meta-analyses (66,68,70).…”

Section: Study Characteristicsmentioning

confidence: 99%

Unravelling the Genetic Link: An Umbrella Review on HLA-B∗15:02 and Anti-Epileptic Drug-induced Stevens–Johnson Syndrome / Toxic Epidermal Necrolysis

Liu,

tham,

Yek

2023

Preprint

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Purpose This umbrella review was conducted to summarize the evidence between association between HLA*1502 allele with various antiepileptic induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Methods Pubmed, Scopus and EMBASE were searched for eligible reviews in May 2023. Study was registered in PROSPERO. Two authors independently screened titles and abstracts and assessed full-text reviews for eligibility. The quality of meta-analyses was appraised with AMSTAR-2 and the quality of case control studies were appraised with Newcastle- Ottawa Scale (NOS). Narrative summaries of each anti-epileptic drug were analysed. Pre-established protocol was registered on the International Prospective Register of Systematic Reviews database (ID: CRD42023403957). Results Included studies are meta-analyses and case control studies evaluating the association of HLA-B*1502 allele with the following antiepileptics: 7 meta-analyses for Carbamazepine (CBZ), 3 meta-analyses for Lamotrigine (LTG), 3 case-control studies for Oxcarbazepine (OXC), 9 case-control studies Phenytoin (PHT) and 4 case-control studies study for Phenobarbitone. The findings of this umbrella review suggest that there is strong association between HLA B-1502 with SJS/TEN for Carbamazepine and Oxcarbazepine and a milder association for Lamotrigine and Phenytoin. Conclusions In summary, although HLA-B*1502 is less likely to be associated with Phenytoin or Lamotrigine -induced SJS/TEN compared to Carbamazepine-induced SJS/TEN, it is a significant risk factor which if carefully screened could potentially reduce development of SJS/TEN. In view of potential morbidity and mortality, HLA-B*1502 testing may be beneficial in patients who are initiating Lamotrigine / Phenytoin therapy. However, further studies are required to examine the association of other alleles with development of SJS/TEN and to explore the possibility of genome-wide association studies prior to initiation of treatment.

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Diagnostic utility of human leukocyte antigen B*15:02 screening in severe carbamazepine hypersensitivity syndrome

Cited by 7 publications

References 48 publications

Advances and novel developments in drug hypersensitivity diagnosis

Advances and novel developments in drug hypersensitivity diagnosis

The pharmacogenomics of carbamazepine-induced cutaneous adverse drug reaction in the South of Vietnam

Unravelling the Genetic Link: An Umbrella Review on HLA-B∗15:02 and Anti-Epileptic Drug-induced Stevens–Johnson Syndrome / Toxic Epidermal Necrolysis

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