PMID- 30580048
OWN - NLM
STAT- MEDLINE
DCOM- 20200731
LR  - 20200731
IS  - 2213-2201 (Electronic)
VI  - 7
IP  - 4
DP  - 2019 Apr
TI  - Efficacy of the HLA-B( *)58:01 Screening Test in Preventing Allopurinol-Induced 
      Severe Cutaneous Adverse Reactions in Patients with Chronic Renal Insufficiency-A 
      Prospective Study.
PG  - 1271-1276
LID - S2213-2198(18)30834-1 [pii]
LID - 10.1016/j.jaip.2018.12.012 [doi]
AB  - BACKGROUND: Thus far, human leukocyte antigen (HLA)-B( *)58:01 has been recognized 
      as the most important risk factor for allopurinol induced severe cutaneous 
      adverse reactions (SCARs). OBJECTIVE: To determine the usefulness of prospective 
      screening for the HLA-B( *)58:01 allele to identify Korean individuals at risk for 
      SCARs induced by allopurinol treatment. METHODS: We prospectively enrolled 542 
      patients with chronic renal insufficiency (CRI) from 10 hospitals nationwide and 
      performed DNA genotyping to determine whether they carried the HLA-B( *)58:01 
      allele. Of these, 503 HLA-B( *)58:01-negative patients (92.8% of total) were 
      treated with allopurinol, and 39 HLA-B( *)58:01-positive patients (7.2%) were 
      treated with febuxostat, an alternative drug. The patients then were followed up 
      biweekly for 90 days using a telephone survey to monitor symptoms of adverse drug 
      reactions, including SCARs. As a control, we used the historical incidence rate 
      of allopurinol-induced SCARs in 4002 patients with CRI from the same hospitals 
      who were enrolled retrospectively. RESULTS: Nineteen patients in the prospective 
      cohort developed mild and transient adverse reactions but none showed 
      allopurinol-induced SCARs. By contrast, we identified 38 patients with 
      allopurinol-induced SCARs (0.95%) in the historical control. The difference in 
      the incidence of allopurinol-induced SCARs between the prospective cohort and 
      historical control was statistically significant (0% vs 0.95%, respectively; P = 
      .029). CONCLUSIONS: The present study demonstrated the clinical usefulness of the 
      HLA-B( *)58:01 screening test before allopurinol administration to prevent 
      allopurinol-induced SCARs in patients with CRI.
CI  - Copyright (c) 2018 American Academy of Allergy, Asthma & Immunology. Published by 
      Elsevier Inc. All rights reserved.
FAU - Park, Heung-Woo
AU  - Park HW
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea. Electronic address: guinea71@snu.ac.kr.
FAU - Kim, Dong Ki
AU  - Kim DK
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea.
FAU - Kim, Sae-Hoon
AU  - Kim SH
AD  - Department of Internal Medicine, Seoul National University Bundang Hospital, 
      Seongnam, Korea.
FAU - Kim, Sejoong
AU  - Kim S
AD  - Department of Internal Medicine, Seoul National University Bundang Hospital, 
      Seongnam, Korea.
FAU - Chae, Dong-Wan
AU  - Chae DW
AD  - Department of Internal Medicine, Seoul National University Bundang Hospital, 
      Seongnam, Korea.
FAU - Yang, Min-Suk
AU  - Yang MS
AD  - Department of Internal Medicine, Seoul National University Boramae Medical 
      Center, Seoul, Korea.
FAU - Oh, Yun Kyu
AU  - Oh YK
AD  - Department of Internal Medicine, Seoul National University Boramae Medical 
      Center, Seoul, Korea.
FAU - Lee, Jung Pyo
AU  - Lee JP
AD  - Department of Internal Medicine, Seoul National University College of Medicine, 
      Seoul, Korea; Department of Internal Medicine, Seoul National University Boramae 
      Medical Center, Seoul, Korea.
FAU - Jung, Jae-Woo
AU  - Jung JW
AD  - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, 
      Korea.
FAU - Shin, Jungho
AU  - Shin J
AD  - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, 
      Korea.
FAU - Hwang, Jin Ho
AU  - Hwang JH
AD  - Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, 
      Korea.
FAU - Kang, Min-Gyu
AU  - Kang MG
AD  - Department of Internal Medicine, Chungbuk National University College of 
      Medicine, Cheongju, Korea.
FAU - Kim, Sun Moon
AU  - Kim SM
AD  - Department of Internal Medicine, Chungbuk National University College of 
      Medicine, Cheongju, Korea.
FAU - Kwon, Soon Kil
AU  - Kwon SK
AD  - Department of Internal Medicine, Chungbuk National University College of 
      Medicine, Cheongju, Korea.
FAU - Kim, Hye-Young
AU  - Kim HY
AD  - Department of Internal Medicine, Chungbuk National University College of 
      Medicine, Cheongju, Korea.
FAU - Kim, Min-Hye
AU  - Kim MH
AD  - Department of Internal Medicine, College of Medicine, Ewha Womans University, 
      Seoul, Korea.
FAU - Kim, Seung-Jung
AU  - Kim SJ
AD  - Department of Internal Medicine, College of Medicine, Ewha Womans University, 
      Seoul, Korea.
FAU - Ryu, Dong-Ryeol
AU  - Ryu DR
AD  - Department of Internal Medicine, College of Medicine, Ewha Womans University, 
      Seoul, Korea.
FAU - Cho, Young-Joo
AU  - Cho YJ
AD  - Department of Internal Medicine, College of Medicine, Ewha Womans University, 
      Seoul, Korea.
FAU - Jee, Young-Koo
AU  - Jee YK
AD  - Department of Internal Medicine, Dankook University College of Medicine, Cheonan, 
      Korea.
FAU - Kim, So Mi
AU  - Kim SM
AD  - Department of Internal Medicine, Dankook University College of Medicine, Cheonan, 
      Korea.
FAU - Lee, Eun Kyoung
AU  - Lee EK
AD  - Department of Internal Medicine, Dankook University College of Medicine, Cheonan, 
      Korea.
FAU - Kim, Ju-Young
AU  - Kim JY
AD  - Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, 
      Korea.
FAU - Cho, Hyun Seop
AU  - Cho HS
AD  - Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, 
      Korea.
FAU - Jeong, Yi Yeong
AU  - Jeong YY
AD  - Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, 
      Korea.
FAU - Kim, Sang-Heon
AU  - Kim SH
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      Korea.
FAU - Jun, Jae-Bum
AU  - Jun JB
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      Korea.
FAU - Park, Joon-Sung
AU  - Park JS
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      Korea.
FAU - Kim, Gheun-Ho
AU  - Kim GH
AD  - Department of Internal Medicine, Hanyang University College of Medicine, Seoul, 
      Korea.
FAU - Kim, Sujeong
AU  - Kim S
AD  - Department of Internal Medicine, School of Medicine, Kyungpook National 
      University, Daegu, Korea.
FAU - Jung, Hee-Yeon
AU  - Jung HY
AD  - Department of Internal Medicine, School of Medicine, Kyungpook National 
      University, Daegu, Korea.
FAU - Lee, Jong-Myung
AU  - Lee JM
AD  - Department of Internal Medicine, School of Medicine, Kyungpook National 
      University, Daegu, Korea.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181221
PL  - United States
TA  - J Allergy Clin Immunol Pract
JT  - The journal of allergy and clinical immunology. In practice
JID - 101597220
RN  - 0 (Allergens)
RN  - 0 (HLA-B Antigens)
RN  - 0 (HLA-B*58:01 antigen)
RN  - 101V0R1N2E (Febuxostat)
RN  - 63CZ7GJN5I (Allopurinol)
SB  - IM
MH  - Aged
MH  - Allergens/immunology
MH  - Allopurinol/*adverse effects/immunology/therapeutic use
MH  - Drug Hypersensitivity/*diagnosis/epidemiology
MH  - Febuxostat/therapeutic use
MH  - Female
MH  - *Genotype
MH  - HLA-B Antigens/*genetics
MH  - Histocompatibility Testing
MH  - Humans
MH  - Korea/epidemiology
MH  - Male
MH  - Mass Screening
MH  - Middle Aged
MH  - Prospective Studies
MH  - Renal Insufficiency, Chronic/*diagnosis/epidemiology
MH  - Risk
MH  - Skin/*pathology
OTO - NOTNLM
OT  - Allopurinol
OT  - Chronic
OT  - Drug hypersensitivity
OT  - HLA-B( *)58:01 allele
OT  - Renal insufficiency
EDAT- 2018/12/24 06:00
MHDA- 2020/08/01 06:00
CRDT- 2018/12/24 06:00
PHST- 2018/08/02 00:00 [received]
PHST- 2018/12/03 00:00 [revised]
PHST- 2018/12/04 00:00 [accepted]
PHST- 2018/12/24 06:00 [pubmed]
PHST- 2020/08/01 06:00 [medline]
PHST- 2018/12/24 06:00 [entrez]
AID - S2213-2198(18)30834-1 [pii]
AID - 10.1016/j.jaip.2018.12.012 [doi]
PST - ppublish
SO  - J Allergy Clin Immunol Pract. 2019 Apr;7(4):1271-1276. doi: 
      10.1016/j.jaip.2018.12.012. Epub 2018 Dec 21.