Dataset Information

Use of HLA-B*58:01 genotyping to prevent allopurinol induced severe cutaneous adverse reactions in Taiwan: national prospective cohort study.

ABSTRACT:

Objective

To evaluate the use of prospective screening for the HLA-B*58:01 allele to identify Taiwanese individuals at risk of severe cutaneous adverse reactions (SCARs) induced by allopurinol treatment.

Design

National prospective cohort study.

Setting

15 medical centres in different regions of Taiwan, from July 2009 to August 2014.

Participants

2926 people who had an indication for allopurinol treatment but had not taken allopurinol previously. Participants were excluded if they had undergone a bone marrow transplant, were not of Han Chinese descent, and had a history of allopurinol induced hypersensitivity. DNA purified from 2910 participants' peripheral blood was used to assess the presence of HLA-B*58:01.

Main outcome measures

Incidence of allopurinol induced SCARs with and without screening.

Results

Participants who tested positive for HLA-B*58:01 (19.6%, n=571) were advised to avoid allopurinol, and were referred to an alternate drug treatment or advised to continue with their prestudy treatment. Participants who tested negative (80.4%, n=2339) were given allopurinol. Participants were interviewed once a week for two months to monitor symptoms. The historical incidence of allopurinol induced SCARs, estimated by the National Health Insurance research database of Taiwan, was used for comparison. Mild, transient rash without blisters developed in 97 (3%) participants during follow-up. None of the participants was admitted to hospital owing to adverse drug reactions. SCARs did not develop in any of the participants receiving allopurinol who screened negative for HLA-B*58:01. By contrast, seven cases of SCARs were expected, based on the estimated historical incidence of allopurinol induced SCARs nationwide (0.30% per year, 95% confidence interval 0.28% to 0.31%; P=0.0026; two side one sample binomial test).

Conclusions

Prospective screening of the HLA-B*58:01 allele, coupled with an alternative drug treatment for carriers, significantly decreased the incidence of allopurinol induced SCARs in Taiwanese medical centres.

SUBMITTER: Ko TM

PROVIDER: S-EPMC4579807 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Use of HLA-B*58:01 genotyping to prevent allopurinol induced severe cutaneous adverse reactions in Taiwan: national prospective cohort study.

Ko Tai-Ming TM Tsai Chang-Youh CY Chen Shih-Yang SY Chen Kuo-Shu KS Yu Kuang-Hui KH Chu Chih-Sheng CS Huang Chung-Ming CM Wang Chrong-Reen CR Weng Chia-Tse CT Yu Chia-Li CL Hsieh Song-Chou SC Tsai Jer-Chia JC Lai Wen-Ter WT Tsai Wen-Chan WC Yin Guang-Dar GD Ou Tsan-Teng TT Cheng Kai-Hung KH Yen Jeng-Hsien JH Liou Teh-Ling TL Lin Tsung-Hsien TH Chen Der-Yuan DY Hsiao Pi-Jung PJ Weng Meng-Yu MY Chen Yi-Ming YM Chen Chen-Hung CH Liu Ming-Fei MF Yen Hsueh-Wei HW Lee Jia-Jung JJ Kuo Mei-Chuan MC Wu Chen-Ching CC Hung Shih-Yuan SY Luo Shue-Fen SF Yang Ya-Hui YH Chuang Hui-Ping HP Chou Yi-Chun YC Liao Hung-Ting HT Wang Chia-Wen CW Huang Chun-Lin CL Chang Chia-Shuo CS Lee Ming-Ta Michael MT Chen Pei P Wong Chih-Shung CS Chen Chien-Hsiun CH Wu Jer-Yuarn JY Chen Yuan-Tsong YT Shen Chen-Yang CY

BMJ (Clinical research ed.) 20150923

<h4>Objective</h4>To evaluate the use of prospective screening for the HLA-B*58:01 allele to identify Taiwanese individuals at risk of severe cutaneous adverse reactions (SCARs) induced by allopurinol treatment.<h4>Design</h4>National prospective cohort study.<h4>Setting</h4>15 medical centres in different regions of Taiwan, from July 2009 to August 2014.<h4>Participants</h4>2926 people who had an indication for allopurinol treatment but had not taken allopurinol previously. Participants were ex ...[more]

PMID: 26399967

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Dataset Information

Use of HLA-B*58:01 genotyping to prevent allopurinol induced severe cutaneous adverse reactions in Taiwan: national prospective cohort study.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Publications

Use of HLA-B*58:01 genotyping to prevent allopurinol induced severe cutaneous adverse reactions in Taiwan: national prospective cohort study.

Similar Datasets

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