Incidence of allopurinol‐induced severe cutaneous adverse drug reaction in Malaysia

Ng, Wei Leik; Lim, Kheng Seang; Hariraj, Vidhya; Lee, Sing Chet; Wo, Wee Kee; Ramli, Azuana; Lai, Pauline Siew Mei; Fong, Si‐Lei; Lim, Jing Ran

doi:10.1111/bcp.15327

Cited by 5 publications

(6 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The notion of targeted screening was proposed by our doctors, where they singled out those of Chinese ethnicity. Previous studies on the prevalence and incidence of allopurinol-induced SCAR in Malaysia support this proposal, but the prevalence and incidence were high among the individuals of Malay ethnicity as well, which is the majority ethnic group in Malaysia [ 7 , 39 , 40 ]. Hence, it would be prudent to consider extending screening to individuals other than those of Chinese ethnicity in Malaysia.…”

Section: Discussionmentioning

confidence: 96%

“…Malaysia [7,39,40]. Hence, it would be prudent to consider extending screening to individuals other than those of Chinese ethnicity in Malaysia.…”

Section: Plos Onementioning

confidence: 99%

“…However, allopurinol is also one of the most common causative drugs for severe cutaneous adverse reactions (SCAR) [3][4][5][6]. In Malaysia, the incidence of allopurinol-induced SCAR was estimated at 2.5 cases per 1000 new allopurinol users, similar to the incidence reported in other Asian countries such as Taiwan and Thailand [7].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Implementing HLA-B*58:01 testing prior to allopurinol initiation in Malaysian primary care setting: A qualitative study from doctors’ and patients’ perspective

Ng,

Hussein,

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Introduction Allopurinol, the first-line treatment for chronic gout, is a common causative drug for severe cutaneous adverse reactions (SCAR). HLA-B*58:01 allele was strongly associated with allopurinol-induced SCAR in Asian countries such as Taiwan, Japan, Thailand and Malaysia. HLA-B*58:01 screening before allopurinol initiation is conditionally recommended in the Southeast-Asian population, but the uptake of this screening is slow in primary care settings, including Malaysia. This study aimed to explore the views and experiences of primary care doctors and patients with gout on implementing HLA-B*58:01 testing in Malaysia as part of a more extensive study exploring the feasibility of implementing it routinely. Methods This qualitative study used in-depth interviews and focus group discussions to obtain information from patients with gout under follow-up in primary care and doctors who cared for them. Patients and doctors shared their gout management experiences and views on implementing HLA-B*58:01 screening in primary care. Data were coded and analysed using thematic analysis. Results 18 patients and 18 doctors from three different healthcare settings (university hospital, public health clinics, private general practitioner clinics) participated. The acceptability to HLA-B*58:01 screening was good among the doctors and patients. We discovered inadequate disclosure of severe side effects of allopurinol by doctors due to concerns about medication refusal by patients, which could potentially be improved by introducing HLA-B*58:01 testing. Barriers to implementation included out-of-pocket costs for patients, the cost-effectiveness of this implementation, lack of established alternative treatment pathway besides allopurinol, counselling burden and concern about genetic data security. Our participants preferred targeted screening for high-risk populations instead of universal screening. Conclusion Implementing HLA-B*58:01 testing in primary care is potentially feasible if a cost-effective, targeted screening policy on high-risk groups can be developed. A clear treatment pathway for patients who test positive should be made available.

show abstract

Section: Discussionmentioning

confidence: 96%

“…Malaysia [7,39,40]. Hence, it would be prudent to consider extending screening to individuals other than those of Chinese ethnicity in Malaysia.…”

Section: Plos Onementioning

confidence: 99%

See 1 more Smart Citation

Implementing HLA-B*58:01 testing prior to allopurinol initiation in Malaysian primary care setting: A qualitative study from doctors’ and patients’ perspective

Ng,

Hussein,

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Due to the renal excretion of oxypurinol, patients with impaired renal function may experience prolonged excretion and elevated level of uric acids, which have been associated with the development of allopurinol hypersensitivity syndrome. 15,[18][19][20] On the other hand, febuxostat is a non-purine selective inhibitor of Xanthine Oxidase (NP-SIXO) and belongs to the class of 2-arylthiazole derivatives. Febuxostat selectively inhibits the Xanthine Oxidase enzyme to reduce serum uric acid levels.…”

Section: Introductionmentioning

confidence: 99%

Hepatic Safety of Febuxostat and Allopurinol for Gout Patients: A Systematic Review of Randomized Controlled Trial

Dewi,

Puspita,

Puspitasari

et al. 2023

TCRM

View full text Add to dashboard Cite

This study aims to systematically review the hepatic safety of febuxostat and allopurinol in adult gout patients. Methods: We searched for information using the following databases: PubMed, Cochrane Library, and Scopus. The inclusion criteria were to review all randomized controlled trials (RCT) that compared allopurinol and febuxostat for adult gout patients that had an assessment of liver function outcomes. Non-English studies on case reports, case series, reviews, and abstracts only were excluded. We extracted information from the studies to answer the research question, ie, study design, publication year, population, sample size, patient characterization, duration, Jadad score, and liver function outcomes. Results: We screened 512 publications from the databases and identified 11 studies that met the inclusion criteria. Ten out of 11 included studies were double-blind RCTs. In the majority of the included studies, no statistically significant differences were observed in terms of hepatic safety data between febuxostat and allopurinol. However, in studies where allopurinol titration was used, it posed a challenge to maintain blinding. Notably, consistent adverse events related to liver function findings were observed across all reviewed RCTs. These abnormal liver function test results sometimes led to study withdrawal based on the investigators' assessment. Nevertheless, the investigators classified most liver function test elevations as mild to moderate in severity. Conclusion: Our analysis concluded that adult gout patients enrolled in the included RCTs exhibited similar hepatic safety profiles for both febuxostat and allopurinol treatment. Liver function abnormalities were identified in all RCTs included in this systematic review. Consequently, it is important for the product labeling information of both allopurinol and febuxostat to present and describe the current safety data to guide healthcare practitioners when prescribing these medications to patients. Pharmacovigilance and post-marketing pharmacoepidemiology data are essential in establishing the comprehensive safety profile.

show abstract

“…Of the total 39 papers found, 7 (17.9%) [3][4][5][6][7][8][9] are based on traditional safety surveillance. This approach relied on data collected through passive reports of ADRs from consumers and health providers, medical literature, and observational databases [10].…”

Section: Introductionmentioning

confidence: 99%

A Mobile App Leveraging Citizenship Engagement to Perform Anonymized Longitudinal Studies in the Context of COVID-19 Adverse Drug Reaction Monitoring: Development and Usability Study

Filippo¹,

Avellone²,

Belingheri³

et al. 2022

JMIR Hum Factors

View full text Add to dashboard Cite

Background Over the past few years, studies have increasingly focused on the development of mobile apps as complementary tools to existing traditional pharmacovigilance surveillance systems for improving and facilitating adverse drug reaction (ADR) reporting. Objective In this research, we evaluated the potentiality of a new mobile app (vaxEffect@UniMiB) to perform longitudinal studies, while preserving the anonymity of the respondents. We applied the app to monitor the ADRs during the COVID-19 vaccination campaign in a sample of the Italian population. Methods We administered vaxEffect@UniMiB to a convenience sample of academic subjects vaccinated at the Milano-Bicocca University hub for COVID-19 during the Italian national vaccination campaign. vaxEffect@UniMiB was developed for both Android and iOS devices. The mobile app asks users to send their medical history and, upon every vaccine administration, their vaccination data and the ADRs that occurred within 7 days postvaccination, making it possible to follow the ADR dynamics for each respondent. The app sends data over the web to an application server. The server, along with receiving all user data, saves the data in a SQL database server and reminds patients to submit vaccine and ADR data by push notifications sent to the mobile app through Firebase Cloud Messaging (FCM). On initial startup of the app, a unique user identifier (UUID) was generated for each respondent, so its anonymity was completely ensured, while enabling longitudinal studies. Results A total of 3712 people were vaccinated during the first vaccination wave. A total of 2733 (73.6%) respondents between the ages of 19 and 80 years, coming from the University of Milano-Bicocca (UniMiB) and the Politecnico of Milan (PoliMi), participated in the survey. Overall, we collected information about vaccination and ADRs to the first vaccine dose for 2226 subjects (60.0% of the first dose vaccinated), to the second dose for 1610 subjects (43.4% of the second dose vaccinated), and, in a nonsponsored fashion, to the third dose for 169 individuals (4.6%). Conclusions vaxEffect@UniMiB was revealed to be the first attempt in performing longitudinal studies to monitor the same subject over time in terms of the reported ADRs after each vaccine administration, while guaranteeing complete anonymity of the subject. A series of aspects contributed to the positive involvement from people in using this app to report their ADRs to vaccination: ease of use, availability from multiple platforms, anonymity of all survey participants and protection of the submitted data, and the health care workers’ support.

show abstract

Incidence of allopurinol‐induced severe cutaneous adverse drug reaction in Malaysia

Cited by 5 publications

References 39 publications

Implementing HLA-B*58:01 testing prior to allopurinol initiation in Malaysian primary care setting: A qualitative study from doctors’ and patients’ perspective

Implementing HLA-B*58:01 testing prior to allopurinol initiation in Malaysian primary care setting: A qualitative study from doctors’ and patients’ perspective

Hepatic Safety of Febuxostat and Allopurinol for Gout Patients: A Systematic Review of Randomized Controlled Trial

A Mobile App Leveraging Citizenship Engagement to Perform Anonymized Longitudinal Studies in the Context of COVID-19 Adverse Drug Reaction Monitoring: Development and Usability Study

Contact Info

Product

Resources

About