Association between HLA‐B1502 and carbamazepine‐induced severe cutaneous adverse drug reactions in a Thai population

Summary Carbamazepine (CBZ) has been reported as the most common culprit drug for Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in several Asian countries including Thailand. A strong association between HLA‐B*1502 and CBZ‐induced SJS/TEN has been reported in Han Chinese but no...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2010-05, Vol.51 (5), p.926-930
Main Authors: Tassaneeyakul, Wichittra, Tiamkao, Somsak, Jantararoungtong, Thawinee, Chen, Pei, Lin, Shu‐Yi, Chen, Wei‐Hsuan, Konyoung, Parinya, Khunarkornsiri, Usanee, Auvichayapat, Narong, Pavakul, Kasemsin, Kulkantrakorn, Kongkiat, Choonhakarn, Charoen, Phonhiamhan, Siranun, Piyatrakul, Namfon, Aungaree, Thiti, Pongpakdee, Sunsanee, Yodnopaglaw, Praphan
Format: Article
Language:English
Subjects:
Adult
Aged
Anticonvulsants - adverse effects
Anticonvulsants - therapeutic use
Anticonvulsants. Antiepileptics. Antiparkinson agents
Asian Continental Ancestry Group - genetics
Asian Continental Ancestry Group - statistics & numerical data
Biological and medical sciences
Carbamazepine
Carbamazepine - adverse effects
Carbamazepine - therapeutic use
Child
Female
Genetic Markers - genetics
Genetic Predisposition to Disease - genetics
Genotype
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
HLA-B Antigens - genetics
HLA-B15 Antigen
HLA‐B1502
Humans
Male
Mass Screening - methods
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Neuropharmacology
Pharmacogenetics
Pharmacology. Drug treatments
Prevalence
Risk Factors
Severe cutaneous adverse drug reactions
Stevens-Johnson Syndrome - chemically induced
Stevens-Johnson Syndrome - epidemiology
Stevens-Johnson Syndrome - etiology
Stevens-Johnson Syndrome - genetics
Stevens‐Johnson syndrome (SJS)
Thailand - epidemiology
Thailand - ethnology
Toxic epidermal necrolysis (TEN)
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Summary:Summary Carbamazepine (CBZ) has been reported as the most common culprit drug for Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) in several Asian countries including Thailand. A strong association between HLA‐B*1502 and CBZ‐induced SJS/TEN has been reported in Han Chinese but not in Caucasian and Japanese populations. A case–control study was conducted to determine whether HLA‐B*1502 is a valid pharmacogenetic test for SJS/TEN caused by CBZ in a Thai population. Among 42 CBZ‐induced patients with SJS/TEN, 37 (88.10%) patients carried the HLA‐B*1502 while only 5 (11.90%) of the CBZ‐tolerant controls had this allele. The risk of CBZ‐induced SJS/TEN was significantly higher in the patients with HLA‐B*1502, with an odds ratio (OR) of 54.76 [95% confidence interval (CI) 14.62–205.13, p = 2.89 × 10−12]. The sensitivity and specificity of HLA‐B*1502 for prediction of CBZ‐induced SJS/TEN were 88.10%. By assuming a 0.27% as a prevalence rate of CBZ‐induced SJS/TEN in a Thai population, the positive predictive value (PPV) and negative predictive value (NPV) of the HLA‐B*1502 were 1.92% and 99.96%. Results from this study suggest that HLA‐B*1502 may be a useful pharmacogenetic test for screening Thai individuals who may be at risk for CBZ‐induced SJS and TEN.
ISSN:0013-9580
1528-1167
DOI:10.1111/j.1528-1167.2010.02533.x