Association between carbamazepine-induced cutaneous adverse drug reactions and the HLA-B*1502 allele among patients in central China

Epilepsy Behav. 2010 Nov;19(3):405-8. doi: 10.1016/j.yebeh.2010.08.007. Epub 2010 Sep 15.

Abstract

The aim of this study was to investigate the association between carbamazepine (CBZ)-induced cutaneous adverse drug reactions (cADRs) and the HLA-B*1502 allele among patients from central China. Eight patients with Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN), 28 with mild maculopapular eruptions (MPEs), 50 CBZ-tolerant controls, and 71 healthy volunteers were recruited. HLA genotyping was performed using the polymerase chain reaction sequence-based typing (SBT) method. As a result, the HLA-B*1502 allele was observed at the following rates: (1) 100% (8/8) among those with CBZ-induced SJS/TEN, (2) 10.7% (3/28) among those with CBZ-induced MPEs; (3) 8.0% (4/50) among CBZ-tolerant controls; (4) 8.5% (6/71) among healthy volunteers. The eight patients with SJS/TEN positive for the HLA-B*1502 allele had an odds ratio (OR) of 184 compared with CBZ-tolerant controls. There was no significant difference in frequency between patients with MPEs and CBZ-tolerant controls (P>0.05). Thus, CBZ-induced SJS/TEN, but not MPEs, is strongly associated with HLA-B*1502. Testing for HLA-B*1502 should be recommended for patients from central China prior to initial CBZ treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged, 80 and over
  • Anticonvulsants / adverse effects*
  • Carbamazepine / adverse effects*
  • Chi-Square Distribution
  • Child, Preschool
  • China
  • Drug-Related Side Effects and Adverse Reactions
  • Epilepsy / drug therapy
  • Female
  • Genotype
  • HLA-B Antigens / genetics*
  • Humans
  • Male
  • Middle Aged
  • Stevens-Johnson Syndrome / chemically induced
  • Stevens-Johnson Syndrome / etiology
  • Stevens-Johnson Syndrome / genetics*
  • Young Adult

Substances

  • Anticonvulsants
  • HLA-B Antigens
  • Carbamazepine