HLA-A*32:01 is strongly associated with vancomycin-induced drug reaction with eosinophilia and systemic symptoms

Konvinse, Katherine C.; Trubiano, Jason A; Pavlos, Rebecca; James, Ian; Shaffer, Christian M.; Bejan, Cosmin Adrian; Schutte, Ryan J.; Ostrov, David A.; Pilkinton, Mark A.; Rosenbach, Misha; Zwerner, Jeffrey P.; Williams, Kristina; Bourke, Jenny; Martínez, Patricia; Rwandamuriye, Francois X.; Chopra, Abha; Watson, Mark W.; Redwood, Alec; White, Katie D.; Mallal, S.; Phillips, Elizabeth

doi:10.1016/j.jaci.2019.01.045

Cited by 138 publications

(105 citation statements)

References 31 publications

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“…Use of EHR data may facilitate PD analyses as clinical observations for drug effects or adverse events are often documented as part of clinical care (e.g., recurrent cardiac events, 20 ACE inhibitor-induced cough, 21 and vancomycin-induced drug reaction). 22 However, phenotyping can impose different challenges depending on how it is defined. A sophisticated phenotyping algorithm may need to be developed to abstract PD measures, and further development of NLP may be necessary in order to utilize EHR data for more diverse population PD studies.…”

Section: Discussionmentioning

confidence: 99%

Development of a System for Postmarketing Population Pharmacokinetic and Pharmacodynamic Studies Using Real‐World Data From Electronic Health Records

Choi

Beck

McNeer

et al. 2020

Clin Pharma and Therapeutics

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Postmarketing population pharmacokinetic (PK) and pharmacodynamic (PD) studies can be useful to capture patient characteristics affecting PK or PD in real‐world settings. These studies require longitudinally measured dose, outcomes, and covariates in large numbers of patients; however, prospective data collection is cost‐prohibitive. Electronic health records (EHRs) can be an excellent source for such data, but there are challenges, including accurate ascertainment of drug dose. We developed a standardized system to prepare datasets from EHRs for population PK/PD studies. Our system handles a variety of tasks involving data extraction from clinical text using a natural language processing algorithm, data processing, and data building. Applying this system, we performed a fentanyl population PK analysis, resulting in comparable parameter estimates to a prior study. This new system makes the EHR data extraction and preparation process more efficient and accurate and provides a powerful tool to facilitate postmarketing population PK/PD studies using information available in EHRs.

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Section: Discussionmentioning

confidence: 99%

Development of a System for Postmarketing Population Pharmacokinetic and Pharmacodynamic Studies Using Real‐World Data From Electronic Health Records

Choi

Beck

McNeer

et al. 2020

Clin Pharma and Therapeutics

Self Cite

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“…Recent literature suggests a strong association of the HLA-A*32:01 alleles in patients of European ancestry who develop DRESS while on vancomycin. The risk of DRESS approaches 20% at four weeks of therapy in those carrying the HLA-A*32:01 allele [58]. While the current HLA allele testing turnaround time is often too prolonged to lead to clinically relevant data, the long latency period of DRESS may allow for testing after initiation of vancomycin in patients who will require a long treatment course and a cost effective HLA gene panel with a 48-h turnaround time is in development [54,58].…”

Section: Drug Rash With Eosinophilia and Systemic Symptomsmentioning

confidence: 99%

Glycopeptide Hypersensitivity and Adverse Reactions

2020

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Glycopeptides, such as vancomycin and teicoplanin, are primarily used in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections, such as cellulitis, endocarditis, meningitis, pneumonia, and septicemia, and are some of the most commonly prescribed parenteral antimicrobials. Parenteral glycopeptides are first-line therapy for severe MRSA infections; however, oral vancomycin is used as a first-line treatment of Clostridioides difficile infections. Also, we currently have the longer-acting lipoglycopeptides, such as dalbavancin, oritavancin, and telavancin to our armamentarium for the treatment of MRSA infections. Lastly, vancomycin is often used as an alternative treatment for patients with β-lactam hypersensitivity. Common adverse effects associated with glycopeptide use include nephrotoxicity, ototoxicity, and Redman Syndrome (RMS). The RMS is often mistaken for a true allergy; however, it is a histamine-related infusion reaction rather than a true immunoglobulin E (IgE)-mediated allergic reaction. Although hypersensitivity to glycopeptides is rare, both immune-mediated and delayed reactions have been reported in the literature. We describe the various types of glycopeptide hypersensitivity reactions associated with glycopeptides and lipoglycopeptides, including IgE-mediated reactions, RMS, and linear immunoglobulin A bullous dermatosis, as well as describe cross-reactivity with other glycopeptides.

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“…DRESS syndrome is a rare but potentially lethal drug-induced hypersensitivity leading to multisystem compromise. Vancomycin is an uncommon cause of DRESS syndrome, but some patients may be genetically predisposed due to human leukocyte antigen (HLA) variations 1. Vancomycin-induced DRESS tends to present with greater incidence of renal impairment compared with other drugs 2.…”

Section: Descriptionmentioning

confidence: 99%