HLA-A∗24:02 associated with lamotrigine-induced cutaneous adverse drug reactions

Abstract

Background: Several studies demonstrated a connection between human leukocyte antigen (HLA)-B∗1502 and lamotrigine (LTG)-induced cutaneous adverse drug reactions (cADRs). The correlation between the HLA-A∗24:02 and LTG-cADRs remains controversial. To examine the associations between HLA-A∗24:02 and LTG-cADRs, we conducted a systematic review and meta-analysis. Methods: We performed a comprehensive search of the literature in several electronic database systems including Cochrane Library, EMBASE and PubMed from inception to January 2020. Review Manager was used to compare the frequencies of HLA-A∗24:02 carriers between the subgroups. Results: A total of 5 studies were eligible, including 197 LTD-cADRs, 396 LTD-tolerant controls, and 2068 population controls. Compared with the LTG-tolerant controls, there was a statistically significant association between the HLA-A∗24:02 allele and LTG-induced cADRs (odds ratios: 1.94, 95% confidence intervals 1.06–3.54; P = .03). Compared with the general population, the relationship between the HLA-A∗24:02 genotype and LTG-induced cADRs was statistically significant (summary odds ratios: 2.12, 95% confidence intervals 1.04–4.30; P = .04). Conclusions: HLA-A∗24:02 may be a risk factor for LTG-cADRs.

Lamotrigine-induced Stevens-Johnson syndrome and toxic epidermal necrolysis in Singapore: A case series

“…A systematic review of 5 studies with drugtolerant and population controls found a statistically significant association between the HLA-A*2402 allele and lamotrigine-induced cutaneous-ADR (cADR) (OR 1.94, 95% CI 1.06-3.54, P=0.03). 9 However, both meta-analyses defined cADRs as inclusive of MPEs, and not solely SCARs. It is noteworthy that only 1 patient in our case series had HLA-B*1502 (data not shown), and 2 patients had HLA-A*2402.…”