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Association between HLA‐B*1502 and carbamazepine‐induced severe cutaneous adverse drug reactions in a Thai population |
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| Authors: | Wichittra Tassaneeyakul Somsak Tiamkao Thawinee Jantararoungtong Pei 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 |
| Affiliation: | 1. Department of Pharmacology;2. Department of Medicine, Khon Kaen University, Khon Kaen, Thailand;3. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan;4. Pharmacy Unit, Udonthani Hospital, Udonthani, Thailand;5. Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand;6. Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand;7. Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand;8. Pharmacy Unit, Nakhonphanom Hospital, Nakhonphanom, Thailand;9. Pharmacy Unit, Suanprung Psychiatric Hospital, Chiangmai, Thailand;10. Department of Medicine, Udonthani Hospital, Udonthani, Thailand;11. Department of Medicine, Bhumibol Adulyadej Hospital, Royal Thai Air Forces, Bangkok, Thailand;12. Department of Medicine, Surin Hospital, Surin, Thailand |
| Abstract: | 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. |
| Keywords: | HLA‐B*1502 Carbamazepine Severe cutaneous adverse drug reactions Stevens‐Johnson syndrome (SJS) Toxic epidermal necrolysis (TEN) |