Association between HLA‐B*1502 Allele and Antiepileptic Drug‐Induced Cutaneous Reactions in Han Chinese

TLDR

HLA‑B*1502 is strongly linked to carbamazepine‑induced Stevens‑Johnson syndrome in Han Chinese, with a 100 % association and odds ratio of 2,504 in a Taiwanese study. The study aimed to determine whether HLA‑B*1502 predicts antiepileptic‑drug–induced severe cutaneous reactions in Hong Kong Han Chinese and to support future screening to prevent such reactions. Twenty‑four patients with cutaneous adverse reactions were matched to 48 antiepileptic‑drug‑tolerant controls for comparison. HLA‑B*1502 was strongly associated with severe cutaneous reactions to carbamazepine, phenytoin, and lamotrigine (OR = 17.6, p = 0.001) but not with maculopapular exanthema.

Abstract

Summary: A previous study conducted in Taiwan found a 100% association between HLA‐B*1502 allele and carbamazepine‐induced Steven s ‐Johnson syndrome (SJS) in Han Chinese subjects, with an extremely high odds ratio compared with carbamazepine‐tolerant subjects (odds ratio = 2,504). We examined this association in 24 Hong Kong Han Chinese subjects who had cutaneous adverse reactions induced by different antiepileptic drugs (AEDs). They were matched with 48 AED‐tolerant controls. HLA‐B*1502 was associated with severe cutaneous reactions (SCR) induced by AEDs, which included carbamazepine, phenytoin, and lamotrigine (p = 0.001, odds ratio = 17.6), but was not associated with maculopapular exanthema (MPE) (p = 0.32). Further studies in larger samples of ethnically matched subjects should be conducted to confirm the findings. Identification of genetic polymorphisms predisposing to development of AED‐induced SCR offers the possibility of avoiding these high‐risk drugs in genetically susceptible individuals.