Utility of human leukocyte antigen-B*58
| Autor: | Wen-Hung Chung, Hung-Yi Chuang, You-Lin Tain, Chien-Ning Hsu, Yaw-Bin Huang, Yen-Hsia Wen, Ching-Hua Ke |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Genotyping Techniques Cross-sectional study Allopurinol Scars 030226 pharmacology & pharmacy 03 medical and health sciences 0302 clinical medicine Asian People Internal medicine Genotype Genetics medicine Humans General Pharmacology Toxicology and Pharmaceutics Medical prescription Molecular Biology Genotyping Genetics (clinical) Aged business.industry Incidence Medical record Incidence (epidemiology) Middle Aged Cross-Sectional Studies Early Diagnosis 030104 developmental biology HLA-B Antigens Molecular Medicine Female Drug Eruptions medicine.symptom business medicine.drug |
| Zdroj: | Pharmacogenetics and Genomics. 29:1-8 |
| ISSN: | 1744-6872 |
| DOI: | 10.1097/fpc.0000000000000359 |
| Popis: | Aim Human leukocyte antigen (HLA-B*58:01) allele screening before allopurinol administration is recommended to prevent gene-mediated severe cutaneous adverse reactions (SCARs). The objective of the analysis was to examine the clinical utility and effects of HLA-B*58:01 genotyping on patient's outcomes in a practice setting. Patients and methods The electronic medical records covering diagnosis, laboratory results, and prescription dispensing for patients who were newly treated with allopurinol or tested for HLA-B*58:01 were obtained from a large medical organization in Taiwan between 2010 and 2014. The uptake of HLA-B*58:01 testing, incidence of allopurinol-associated SCAR, and changes in urate-lowering agent utilization were assessed. Results A total of 17 532 allopurinol new users were identified from 2010 to 2014, and the HLA-B*58:01 test was ordered for 2844 (21.76%) of 13 069 new users when available between 2011 and 2014 in the study. The allopurinol-related SCAR events decreased from 0.21% (22/4460) to 0 (0/2167) after the introduction of HLA-B*58:01 testing, accompanied by a gradual increase from 8% (326/4207) to 31% (674/2167) in genotype testing rate. However, the HLA-B*58:01 testing performed before allopurinol prescription was 60.34%, and ~40% of patients were tested after already taking allopurinol. A shift from allopurinol to other urate-lowering agent regimens appeared among new allopurinol users. Conclusion HLA-B*58:01 test was associated with the prevention of allopurinol-induced SCAR. The clinical utility of genotype testing may not be consistent with recommendations for testing, and treatment alternatives are a competitive intervention associated with effective implications in a real-world setting. |
| Databáze: | OpenAIRE |
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