Association between HLA-B*58:01 allele and severe cutaneous adverse reactions with allopurinol in Han Chinese in Hong Kong

Abstract

This study confirmed the strong association between the HLA-B*58:01 and allopurinol-induced SCAR in Hong Kong Han Chinese patients. A screening test for the HLA-B*58:01 allele should effectively reduce the risk for allopurinol-induced SCAR in Chinese populations.

Allopurinol for the treatment of chronic kidney disease: asystematic review

“…49 The proportion of males included in studies also varied by study. Most studies reported that the majority of patients were male, with males being a minority in only three studies 48,49,61 For studies that included a control group, 13,14,47,48,51,[53][54][55]59,68,70 the proportion of males was well balanced in both arms in only two. 13,68 The majority of studies had a greater proportion of males in the control group 48,51,[53][54][55]59,70 than the allopurinol group.…”

“…Most studies reported that the majority of patients were male, with males being a minority in only three studies 48,49,61 For studies that included a control group, 13,14,47,48,51,[53][54][55]59,68,70 the proportion of males was well balanced in both arms in only two. 13,68 The majority of studies had a greater proportion of males in the control group 48,51,[53][54][55]59,70 than the allopurinol group. 14,47 Thirteen studies [50][51][52][53][54][55][56]58,61,63,[68][69][70] explicitly reported the ethnicity of their subjects, although the ethnicity is implied (to be European) in another.…”

“…13,68 The majority of studies had a greater proportion of males in the control group 48,51,[53][54][55]59,70 than the allopurinol group. 14,47 Thirteen studies [50][51][52][53][54][55][56]58,61,63,[68][69][70] explicitly reported the ethnicity of their subjects, although the ethnicity is implied (to be European) in another. 49 Four of these studies 50,52,68,69 were conducted in New Zealand, where the ethnicity of patients varied across studies.…”

HLA-B*5801 Should Be Used to Screen for Risk of Stevens-Johnson Syndrome in Family Members of Han Chinese Patients Commencing Allopurinol Therapy

“…Across studies thus far, all Han Chinese patients with allopurinol-induced SJS were found to be HLA-B*5801-positive 3,7,9 (Table 2). However, HLA-B*5801 has a 20% carriage rate in Han Chinese 3 , meaning 1 in 5 Han Chinese patients starting allopurinol would be denied it if primary screening were applied.…”

“…A multinational study reported that allopurinol is the most common drug associated with SJS and toxic epidermal necrolysis 2 . Genomic studies have shown that the HLA-B*5801 allele is a strong risk factor (OR 34-348) for developing allopurinol-induced SJS 3,4,5,6,7,8 . However, the clinical utility of HLA-B*5801 is unclear.…”