Association of HLA-B*5801 allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis

BMC Medical Genetics

Research Article

Ratchadaporn Somkrua¹  Nathorn Chaiyakunapruk²  Manupat Lohitnavy³  Elizabeth E Eickman⁴  Surasak Saokaew⁵ 

[1] Center of Pharmaceutical Outcomes Research (CPOR), Naresuan University, Phitsanulok, Thailand;Center of Pharmaceutical Outcomes Research (CPOR), Naresuan University, Phitsanulok, Thailand;Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand;School of Population Health, University of Queensland, Brisbane, Australia;School of Pharmacy, University of Wisconsin, Madison, USA;Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand;Department of Pharmacy Practice, University of Nebraska Medical Center, Omaha, Nebraska, USA;School of Pharmacy, University of Phayao, Phayao, Thailand;

关键词: Human leukocyte antigen;    severe cutaneous reaction;    Stevens-Johnson syndrome;    toxic epidermal necrolysis;    allopurinol;    meta-analysis;   

DOI  :  10.1186/1471-2350-12-118

 received in 2011-02-24, accepted in 2011-09-09,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundDespite some studies suggesting a possible association between human leukocyte antigen, HLA-B*5801 and allopurinol induced Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), the evidence of association and its magnitude remain inconclusive. This study aims to systematically review and meta-analyze the association between HLA-B*5801 allele and allopurinol-induced SJS/TEN.MethodsA comprehensive search was performed in databases including MEDLINE, Pre-MEDLINE, Cochrane Library, EMBASE, International Pharmaceutical Abstracts (IPA), CINAHL, PsychInfo, the WHO International, Clinical Trial Registry, and ClinicalTrial.gov from their inceptions to June 2011. Only studies investigating association between HLA-B*5801 with allopurinol-induced SJS/TEN were included. All studies were extracted by two independent authors. The primary analysis was the carrier frequency of HLA-B*5801 comparison between allopurinol-induced SJS/TEN cases and each comparative group. The pooled odds ratios were calculated using a random effect model.ResultsA total of 4 studies with 55 SJS/TEN cases and 678 matched-controls (allopurinol-tolerant control) was identified, while 5 studies with 69 SJS/TEN cases and 3378 population-controls (general population) were found. SJS/TEN cases were found to be significantly associated with HLA-B*5801 allele in both groups of studies with matched-control (OR 96.60, 95%CI 24.49-381.00, p < 0.001) and population-control (OR 79.28, 95%CI 41.51-151.35, p < 0.001). Subgroup analysis for Asian and Non-Asian population yielded similar findings.ConclusionWe found a strong and significant association between HLA-B*5801 and allopurinol-induced SJS/TEN. Therefore, HLA-B*5801 allele screening may be considered in patients who will be treated with allopurinol.

【 授权许可】

Unknown   
© Somkrua et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.