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Association between HLA‐B*1502 and carbamazepine‐induced severe cutaneous adverse drug reactions in a Thai population

2010; Wiley; Volume: 51; Issue: 5 Linguagem: Inglês

10.1111/j.1528-1167.2010.02533.x

1528-1167

Wichittra Tassaneeyakul, Somsak Tiamkao, Thawinee Jantararoungtong, Pei‐Jer Chen, Shu‐Yi Lin, Wei-Hsuan Chen, Parinya Konyoung, Usanee Khunarkornsiri, Narong Auvichayapat, Kasemsin Pavakul, Kongkiat Kulkantrakorn, Charoen Choonhakarn, Siranun Phonhiamhan, Namfon Piyatrakul, Thiti Aungaree, Sunsanee Pongpakdee, Praphan Yodnopaglaw,

Contact Dermatitis and Allergies

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.