HLA-A*31:01等位基因与拉莫三嗪所致皮肤不良反应关联性的Meta分析

目的：近年来，多项研究探讨了人类白细胞抗原HLA-A*31：01等位基因与抗癫痫药拉莫三嗪（LTG）所致皮肤型药物不良反应（cADRs）的关联性，但目前尚无确定的结论。因此，本研究拟通过一项Meta分析来系统评价HLA-A*31：01等位基因与拉莫三嗪所致皮肤不良反应（LTG-cADRs）的关联性。方法：通过计算机全面检索生物医学文献库PubMed、Embase、The Cochrane Library、Medline、CNKI、VIP和万方数据库，检索时间截止至2018年7月24日，纳入探讨了HLA-A*31：01与LTG-cADRs相关性的研究，并采用RevMan 5.3软件进行Meta分析。结果：共纳入5项病例对照研究，123例LTG-cADRs癫痫患者，137例拉莫三嗪耐受（LTG-Tolerant）癫痫患者，2 837例正常人群。Meta分析结果显示，在与LTG-Tolerant组的比较中，HLA-A*31：01基因型与LTG所致的cADRs存在显著相关性（OR=2.87，95% CI：1.11~7.40，P=0.03）。而在与正常人群组的比较中，HLA-A*31：01基因型与LTG所致的cADRs不存在显著相关性（OR=1.34，95% CI：0.34~5.28，P=0.67）。结论：本研究证明，HLA-A*31：01基因型可能是LTG所致cADRs的遗传风险因素。

Assoation between HLA-A*31: 01 and lamotrigine-induced cutaneous adverse reaction: a meta-analysis

OBJECTIVE In recent years, a number of studies have examined the assoation between the human leukocyte antigen HLA-A*31:01 allele and cutaneous adverse drug reactions (cADRs) caused by lamotrigine (LTG). However, the relationship between HLA-A*31:01 and cADRs remains unknown. This study aims to analyze this assoation in the published literature. METHODS PubMed, Embase, the Cochrane Library, Medline, CNKI, VIP, Wanfang Database (from their inception to July 24th, 2018) were searched for case-control studies. RevMan 5.3 software was used for meta-analysis.RESULTS Five case-control studies with 123 LTG-cADRs patients, 137 LTG-tolerant patients and 2 837 general were included. Meta-analysis results showed that in comparison with the LTG-Tolerant group, a significant correlation was found between HLA-A*31:01 genotype and LTG-cADRs (OR=2.87, 95%CI:1.11-7.40, P=0.03). When compared with population control group, there was no significant assoation between the HLA-A*31:01 genotype and LTG-induced cADRs (OR=1.34, 95% CI:0.34-5.28, P=0.67). CONCLUSION This study demonstrates that HLA-A*31:01 genotype may be a genetic risk factor for cADRs caused by LTG.