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Reducing severe cutaneous adverse and type B adverse drug reactions using pre-stored human leukocyte antigen genotypes
- Title
- Reducing severe cutaneous adverse and type B adverse drug reactions using pre-stored human leukocyte antigen genotypes
- Authors
- Lee K.H.; Kang D.Y.; Kim H.H.; Kim Y.J.; Kim H.J.; Kim J.H.; Song E.Y.; Yun J.; Kang H.-R.
- Ewha Authors
- 김이준
- SCOPUS Author ID
- 김이준
- Issue Date
- 2022
- Journal Title
- Clinical and Translational Allergy
- ISSN
- 2045-7022
- Citation
- Clinical and Translational Allergy vol. 12, no. 1
- Keywords
- humanes leukozytenantigen; pharmakogenomik; präventive genotypisierung; uberempfindlichkeit; unerwünschte arzneimittelwirkung
- Publisher
- John Wiley and Sons Inc
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background: Several type B adverse drug reactions (ADRs), especially severe cutaneous adverse reactions (SCARs), are associated with particular human leukocyte antigen (HLA) genotypes. However, pre-stored HLA information obtained from other clinical workups has not been used to prevent ADRs. We aimed to simulate the preemptive use of pre-stored HLA information in electronic medical records to evaluate whether this information can prevent ADRs. Methods: We analyzed the incidence and the risk of ADRs for selected HLA alleles (HLA-B*57:01, HLA-B*58:01, HLA-A*31:01, HLA-B*15:02, HLA-B*15:11, HLA-B*13:01, HLA-B*59:01, and HLA-A*32:01) and seven drugs (abacavir, allopurinol, carbamazepine, oxcarbazepine, dapsone, methazolamide, and vancomycin) using pre-stored HLA information of transplant patients based on the Pharmacogenomics Knowledge Base guidelines and experts' consensus. Results: Among 11,988 HLA-tested transplant patients, 4092 (34.1%) had high-risk HLA alleles, 4583 (38.2%) were prescribed risk drugs, and 580 (4.8%) experienced type B ADRs. Patients with HLA-B*58:01 had a significantly higher incidence of type B ADR and SCARs associated with allopurinol use than that of patients without HLA-B*58:01 (17.2% vs. 11.9%, odds ratio [OR] 1.53 [95% confidence interval {CI} 1.09–2.13], p = 0.001, 2.3% versus 0.3%, OR 7.13 [95% CI 2.19–22.69], p < 0.001). Higher risks of type B ADR and SCARs were observed in patients taking carbamazepine or oxcarbazepine if they had one of HLA-A*31:01, HLA-B*15:02, or HLA-B*15:11 alleles. Vancomycin and dapsone use in HLA-A*32:01 and HLA-B*13:01 carriers, respectively, showed trends toward increased risk of type B ADRs. Conclusion: Utilization of pre-stored HLA data can prevent type B ADRs including SCARs by screening high-risk patients. © 2022 The Authors. Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.
- DOI
- 10.1002/clt2.12098
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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