Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans
- Authors
- Kim, Sae-Hoon; Lee, Kyung Wha; Song, Woo-Jung; Kim, Sang-Heon; Jee, Young-Koo; Lee, Sang-Min; Kang, Hye-Ryun; Park, Heung-Woo; Cho, Sang-Heon; Park, Seong-Ho; Min, Kyung-Up; Chang, Yoon-Seok
- Issue Date
- Nov-2011
- Publisher
- ELSEVIER
- Keywords
- Carbamazepine; Human leukocyte antigen (HLA); Stevens-Johnson syndrome (SJS); Toxic epidermal necrolysis (TEN); Hypersensitivity syndrome (HSS)
- Citation
- EPILEPSY RESEARCH, v.97, no.1-2, pp.190 - 197
- Indexed
- SCIE
SCOPUS
- Journal Title
- EPILEPSY RESEARCH
- Volume
- 97
- Number
- 1-2
- Start Page
- 190
- End Page
- 197
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/167214
- DOI
- 10.1016/j.eplepsyres.2011.08.010
- ISSN
- 0920-1211
- Abstract
- Background: Although the US FDA recommends screening for HLA-B*1502 allele in most of Asian ancestry before initiating carbamazepine therapy, the HLA associations with carbamazepine hypersensitivity in non-Chinese Asian populations remain unclear. This study investigated the association between the HLA class I genotype and carbamazepine-induced severe cutaneous adverse reaction (SCAR) in Koreans. Methods: Twenty-four patients who had developed carbamazepine-induced SCAR (7 Stevens-Johnson syndrome (SJS), 17 drug hypersensitivity syndrome (HSS)), 50 carbamazepine-tolerant controls from the Korean Pharmacogenetic Adverse Drug Reaction Research Network and data of 485 Korean general population from a previously published study were recruited. HLA-A, -B, and -C genotyping was performed by direct DNA sequence analysis. Results: Only one of the seven SJS patients was positive for the B*1502 allele, but the frequency of B*1511 was much higher in the patients with CBZ-SJS than in the CBZ-tolerant control patients (P = 0.011, P-c = not significant; OR = 18.0(2.3-141.2)). The frequencies of A*3101 in carbamazepine-induced HSS and SCAR were significantly higher than those in carbamazepine-tolerant controls (P-c = 0.011, OR = 8.8(2.5-30.7) and P-c = 0.013, OR = 7.3(2.3-22.5), respectively). The frequencies of B*1511 in carbamazepine-SJS and A*3101 in carbamazepine-HSS/SCAR were significantly higher than those in the general population. Conclusions: HLA-B*1502 does not seem to be an effective predictive marker for carbamazepine-induced SCAR, while HLA-B*1511 and A*3101 was associated with carbamazepine-induced SJS and HSS/SCAR respectively in the Korean population.
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