PMID- 28203102
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 1178-7066 (Print)
IS  - 1178-7066 (Electronic)
IS  - 1178-7066 (Linking)
VI  - 10
DP  - 2017
TI  - The HLA-A*31:01 allele: influence on carbamazepine treatment.
PG  - 29-38
LID - 10.2147/PGPM.S108598 [doi]
AB  - Carbamazepine (CBZ) is an effective anticonvulsant that can sometimes cause 
      hypersensitivity reactions that vary in frequency and severity. Strong 
      associations have been reported between specific human leukocyte antigen (HLA) 
      alleles and susceptibility to CBZ hypersensitivity reactions. Screening for 
      HLA-B*15:02 is mandated in patients from South East Asia because of a strong 
      association with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis 
      (TEN). HLA-A*31:01 predisposes to multiple phenotypes of CBZ hypersensitivity 
      including maculopapular exanthema, hypersensitivity syndrome, and SJS/TEN in a 
      range of populations including Europeans, Japanese, South Koreans and Han 
      Chinese, although the effect size varies between the different phenotypes and 
      populations. Between 47 Caucasians and 67 Japanese patients would need to be 
      tested for HLA-A*31:01 in order to avoid a single case of CBZ hypersensitivity. A 
      cost-effectiveness study has demonstrated that HLA-A*31:01 screening would be 
      cost-effective. Patient preference assessment has also revealed that patients 
      prefer pharmacogenetic screening and prescription of alternative anticonvulsants 
      compared to current standard of practice without pharmacogenetic testing. For 
      patients who test positive for HLA-A*31:01, alternative treatments are available. 
      When alternatives have failed or are unavailable, HLA-A*31:01 testing can alert 
      clinicians to 1) patients who are at increased risk of CBZ hypersensitivity who 
      can then be targeted for more intensive monitoring and 2) increase diagnostic 
      certainty in cases where hypersensitivity has already occurred, so patients can 
      be advised to avoid structurally related drugs in the future. On the basis of the 
      current evidence, we would favor screening all patients for HLA-A*31:01 and 
      HLA-B*15:02 prior to starting CBZ therapy.
FAU - Yip, Vincent Lai Ming
AU  - Yip VL
AD  - MRC Centre for Drug Safety Science, Institute of Translational Medicine, 
      Department of Molecular and Clinical Pharmacology, University of Liverpool; 
      Department of Clinical Pharmacology, The Royal Liverpool and Broadgreen 
      University Hospital NHS Trust, Liverpool, UK.
FAU - Pirmohamed, Munir
AU  - Pirmohamed M
AD  - MRC Centre for Drug Safety Science, Institute of Translational Medicine, 
      Department of Molecular and Clinical Pharmacology, University of Liverpool; 
      Department of Clinical Pharmacology, The Royal Liverpool and Broadgreen 
      University Hospital NHS Trust, Liverpool, UK.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170131
PL  - New Zealand
TA  - Pharmgenomics Pers Med
JT  - Pharmacogenomics and personalized medicine
JID - 101514107
PMC - PMC5293506
OTO - NOTNLM
OT  - HLA
OT  - adverse drug reaction
OT  - carbamazepine
OT  - hypersensitivity
OT  - oxcarbazepine
OT  - pharmacogenetics
COIS- Disclosure The authors report no conflicts of interest in this work.
EDAT- 2017/02/17 06:00
MHDA- 2017/02/17 06:01
PMCR- 2017/01/31
CRDT- 2017/02/17 06:00
PHST- 2017/02/17 06:00 [entrez]
PHST- 2017/02/17 06:00 [pubmed]
PHST- 2017/02/17 06:01 [medline]
PHST- 2017/01/31 00:00 [pmc-release]
AID - pgpm-10-029 [pii]
AID - 10.2147/PGPM.S108598 [doi]
PST - epublish
SO  - Pharmgenomics Pers Med. 2017 Jan 31;10:29-38. doi: 10.2147/PGPM.S108598. 
      eCollection 2017.