Association of HLA-B*1502 allele and carbamazepine induced severe adverse cutaneous drug reaction among Asians, a review
- Author:
Kheng Seang Lim
;
Patrick Kwan
;
Chong Tin Tan
- Publication Type:Review
- From:Neurology Asia
2008;13(1):15-21
- CountryMalaysia
- Language:English
-
Abstract:
Strong association between HLA B*1502 and carbamazepine-induced Steven-Johnson syndrome (SJS)
and toxic epidermal necrolysis (TEN) was demonstrated among Han Chinese in 2004. Studies from
Europe showed that the HLA B*1502 is not a universal marker for SJS/TEN, but is ethnicity specific
for Asians. Reports across Asia has shown that the prevalence of HLA B*1502 is high among Han
Chinese (5-15%), Malays (12-15%), and Thais (8-27%), but low among Japan, Korea, Sri Lanka,
and most ethnic groups in India. Other than Han Chinese, the association between HLA B*1502 and
carbamazepine-induced SJS-TEN is also seen among the Thais and Malay. There is urgent need for
further studies to determine the prevalence of SJS/TEN, and HLA B*1502 in the various ethnic groups
in Asia, and its association with carbamazepine-induced SJS-TEN in each of these ethnic groups. In
view of the significant morbidity and mortality in SJS-TEN, facilities should be developed to allow
for screening of HLA B*1502 before carbamazepine is prescribed to the Hans Chinese, Malays and
Thais. For those who experience no adverse cutaneous reaction after 3 months use of carbamazepine,
the risk of SJS/TEN is low, and the drugs can be continued.
- Full text:P020150901389053643940.pdf
