PMID- 34213582
OWN - NLM
STAT- MEDLINE
DCOM- 20220726
LR  - 20220727
IS  - 1432-069X (Electronic)
IS  - 0340-3696 (Linking)
VI  - 314
IP  - 7
DP  - 2022 Sep
TI  - HLA-B*58:01 screening to prevent allopurinol-induced severe cutaneous adverse 
      reactions in Chinese patients with chronic kidney disease.
PG  - 651-659
LID - 10.1007/s00403-021-02258-3 [doi]
AB  - Human leukocyte antigen (HLA)-B*58:01 allele is a significant risk factor for 
      allopurinol-induced severe cutaneous adverse reactions (SCARs) which is 
      potentially fatal. In some studies, chronic kidney disease (CKD) was also 
      implicated to compound the risk of SCARs. We aim to investigate if pre-treatment 
      HLA-B*58:01 screening can prevent allopurinol-induced SCARs in Chinese patients 
      with CKD and its cost-effectiveness. We prospectively recruited Chinese CKD 
      patients who required allopurinol during 2011-2015 and performed pre-treatment 
      HLA testing (HLA screening group). Patients tested positive for HLA-B*58:01 were 
      refrained from allopurinol while those tested negative were prescribed 
      allopurinol. The incidence of SCARs in the HLA screening group was compared with 
      the historical control in previous 5 years and the cost-effectiveness of HLA 
      testing was analyzed. In the historical control (2006-2010), 3605 patients on 
      allopurinol were screened, 22 out of 1027 (2.14%) CKD Chinese patients newly 
      started on allopurinol developed SCARs, including 6 SJS/TEN. In the HLA screening 
      group, 28 out of 192 patients (14.6%) tested HLA-B*58:01 positive were advised to 
      avoid allopurinol; 156 out of 164 HLA-B*58:01-negative patients received 
      allopurinol and none developed SCARs. The incidence rate of SCARs was 
      significantly lower in the HLA screening group compared with controls (0% vs 
      2.14% respectively, p = 0.037*). The targeted HLA screening approach was 
      associated with lower healthcare costs compared with no HLA screening (US$ 92,430 
      vs US$ 281,226). Pre-treatment HLA-B*58:01 screening is cost-effective to target 
      on patients with CKD in Chinese to prevent allopurinol-induced SCARs.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, 
      part of Springer Nature.
FAU - Wong, Christina Sze-Man
AU  - Wong CS
AD  - Division of Dermatology, Department of Medicine, The University of Hong Kong, 
      Hong Kong SAR, China.
FAU - Yeung, Chi-Keung
AU  - Yeung CK
AD  - Division of Dermatology, Department of Medicine, The University of Hong Kong, 
      Hong Kong SAR, China.
FAU - Chan, Chun-Yin
AU  - Chan CY
AD  - Division of Dermatology, Department of Medicine, The University of Hong Kong, 
      Hong Kong SAR, China.
FAU - Yap, Desmond Yat-Hin
AU  - Yap DY
AD  - Division of Nephrology, Department of Medicine, The University of Hong Kong, Hong 
      Kong SAR, China.
FAU - Tang, Sydney Chi-Wai
AU  - Tang SC
AD  - Division of Nephrology, Department of Medicine, The University of Hong Kong, Hong 
      Kong SAR, China.
FAU - Cheung, Bernard Man-Yung
AU  - Cheung BM
AD  - Division of Clinical Pharmacology, Department of Medicine, The University of Hong 
      Kong, Hong Kong SAR, China.
FAU - Kwok, Janette Siu-Yin
AU  - Kwok JS
AD  - Division of Transplantation and Immunogenetics, Department of Pathology, Queen 
      Mary Hospital, Hong Kong SAR, China.
FAU - Chan, Henry Hin-Lee
AU  - Chan HH
AUID- ORCID: 0000-0002-9657-1435
AD  - Division of Dermatology, Department of Medicine, The University of Hong Kong, 
      Hong Kong SAR, China. hhlchan@hkucc.hku.hk.
AD  - Dermatology and Laser Centre, 1 Wellington Street, Central, Hong Kong SAR, China. 
      hhlchan@hkucc.hku.hk.
LA  - eng
GR  - 212218/WT_/Wellcome Trust/United Kingdom
GR  - 212218/WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
DEP - 20210702
PL  - Germany
TA  - Arch Dermatol Res
JT  - Archives of dermatological research
JID - 8000462
RN  - 0 (HLA-B Antigens)
RN  - 63CZ7GJN5I (Allopurinol)
SB  - IM
MH  - *Allopurinol/adverse effects
MH  - China/epidemiology
MH  - *Drug-Related Side Effects and Adverse Reactions/complications
MH  - *HLA-B Antigens/genetics
MH  - Humans
MH  - *Renal Insufficiency, Chronic/complications
MH  - *Stevens-Johnson Syndrome/etiology
OTO - NOTNLM
OT  - Allopurinol
OT  - Chronic kidney disease
OT  - HLA-B*58:01
OT  - SCARs
OT  - SJS
OT  - TEN
EDAT- 2021/07/03 06:00
MHDA- 2022/07/27 06:00
CRDT- 2021/07/02 12:18
PHST- 2021/02/10 00:00 [received]
PHST- 2021/06/10 00:00 [accepted]
PHST- 2021/06/09 00:00 [revised]
PHST- 2021/07/03 06:00 [pubmed]
PHST- 2022/07/27 06:00 [medline]
PHST- 2021/07/02 12:18 [entrez]
AID - 10.1007/s00403-021-02258-3 [pii]
AID - 10.1007/s00403-021-02258-3 [doi]
PST - ppublish
SO  - Arch Dermatol Res. 2022 Sep;314(7):651-659. doi: 10.1007/s00403-021-02258-3. Epub 
      2021 Jul 2.