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

HLA-B*58:01is a risk factor for allopurinol-induced DRESS and Stevens-Johnson syndrome/toxic epidermal necrolysis in a Portuguese population

“…It would be better limited to individuals with other risk factors for CADR, namely those with chronic renal insufficiency, those on multiple drugs, especially diuretics, or patients with Asian and Indian-Asian ancestry, 6 particularly those with relatives who developed a CADR from allopurinol. 50 …”

HLA-B*58:01 Genotyping to Prevent Cases of DRESS and SJS/TEN in East Asians Treated with Allopurinol—A Canadian Missed Opportunity

“…2,15,16 An Australian study conducted in 2013 suggested that family members of patients who test positive for HLA-B*58:01 would also benefit from predictive testing. 17 Such actions may result in reduced morbidity, mortality, and healthcare costs in populations with a high proportion of individuals with Asian descent. Meticulous genotyping in Taiwan has reduced the incidence of severe reactions to allopurinol.…”

Drug Eruptions Induced by Allopurinol Associated with HLA-BFNx015801

“…In contrast, the presence of this allele was lower (13.3%) in healthy population controls, in patients who had SCARs induced by other medications, and patients who were allopurinol tolerant. Lee et al [4] in a study to determine the presence of HLA-B*5801 allele in the immediate family members of a HLA-B*5801 allele positive male patient who experienced allopurinol-induced Stevens-Johnson syndrome, found his brother who had taken allopurinol for 10 years for gouty arthritis to be HLA-B*5801 allele negative. Interestingly, eight patients who developed milder cutaneous adverse drug reactions such as erythema multiforme major or a maculopapular rash did not carry the allele.…”

“…Allopurinol, a commonly prescribed medication for gout and hyperuricemia, is a frequent cause of severe cutaneous adverse reactions (SCARs), which include drug hypersensitivity syndrome, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). [3] Recent investigations suggest that HLA-B*5801 is a very strong marker for allopurinol-induced cutaneous adverse drug reactions, especially severe cutaneous adverse reactions (SCARs) [4][5][6][7][8][9][10][11][12] [ Table 2]. A total of 10 studies with 219 patients with allopurinol-induced cutaneous adverse drug reactions were identified, and 193 (87.3%) of these patients were found to carry the HLA-B*5801 allele.…”