Association between HLA-B*1502 allele and antiepileptic drug-induced cutaneous reactions in Han Chinese

Epilepsia. 2007 May;48(5):1015-8. doi: 10.1111/j.1528-1167.2007.01022.x.

Abstract

A previous study conducted in Taiwan found a 100% association between HLA-B*1502 allele and carbamazepine-induced Stevens-Johnson syndrome (SJS) in Han Chinese subjects, with an extremely high odds ratio compared with carbamazepine-tolerant subjects (odds ratio = 2,504). We examined this association in 24 Hong Kong Han Chinese subjects who had cutaneous adverse reactions induced by different antiepileptic drugs (AEDs). They were matched with 48 AED-tolerant controls. HLA-B*1502 was associated with severe cutaneous reactions (SCR) induced by AEDs, which included carbamazepine, phenytoin, and lamotrigine (p = 0.001, odds ratio = 17.6), but was not associated with maculopapular exanthema (MPE) (p = 0.32). Further studies in larger samples of ethnically matched subjects should be conducted to confirm the findings. Identification of genetic polymorphisms predisposing to development of AED-induced SCR offers the possibility of avoiding these high-risk drugs in genetically susceptible individuals.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Alleles
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use
  • Asian People / genetics*
  • Carbamazepine / adverse effects
  • Carbamazepine / therapeutic use
  • Case-Control Studies
  • Child
  • Drug Eruptions / ethnology*
  • Drug Eruptions / etiology*
  • Drug Eruptions / genetics
  • Drug Hypersensitivity / ethnology
  • Drug Hypersensitivity / genetics
  • Epilepsy / drug therapy*
  • Epilepsy / ethnology
  • Epilepsy / genetics
  • Female
  • Genetic Predisposition to Disease / ethnology
  • HLA-B Antigens / genetics*
  • HLA-B15 Antigen
  • Hong Kong
  • Humans
  • Lamotrigine
  • Male
  • Middle Aged
  • Pharmacogenetics
  • Phenytoin / adverse effects
  • Phenytoin / therapeutic use
  • Polymorphism, Genetic
  • Stevens-Johnson Syndrome / chemically induced
  • Stevens-Johnson Syndrome / ethnology
  • Stevens-Johnson Syndrome / genetics
  • Triazines / adverse effects
  • Triazines / therapeutic use

Substances

  • Anticonvulsants
  • HLA-B Antigens
  • HLA-B*15:02 antigen
  • HLA-B15 Antigen
  • Triazines
  • Carbamazepine
  • Phenytoin
  • Lamotrigine