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

• Main Authors: Lohitnavy Manupat (Author), Saokaew Surasak (Author), Eickman Elizabeth E (Author), Somkrua Ratchadaporn (Author), Chaiyakunapruk Nathorn (Author)
• Format: Book
• Published: BMC, 2011-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/1471-2350-12-118; 1471-2350
• Keywords: Human leukocyte antigen; severe cutaneous reaction; Stevens-Johnson syndrome; toxic epidermal necrolysis; allopurinol; meta-analysis; Internal medicine; RC31-1245; Genetics; QH426-470
• Source: BMC Medical Genetics, Vol 12, Iss 1, p 118 (2011)

<p>Abstract</p> <p>Background</p> <p>Despite some studies suggesting a possible association between human leukocyte antigen, <it>HLA-B*5801 </it>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 <it>HLA-B*5801 </it>allele and allopurinol-induced SJS/TEN.</p> <p>Methods</p> <p>A 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 <it>HLA-B*5801 </it>with allopurinol-induced SJS/TEN were included. All studies were extracted by two independent authors. The primary analysis was the carrier frequency of <it>HLA-B*5801 </it>comparison between allopurinol-induced SJS/TEN cases and each comparative group. The pooled odds ratios were calculated using a random effect model.</p> <p>Results</p> <p>A 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 <it>HLA-B*5801 </it>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.</p> <p>Conclusion</p> <p>We found a strong and significant association between <it>HLA-B*5801 </it>and allopurinol-induced SJS/TEN. Therefore, <it>HLA-B*5801 </it>allele screening may be considered in patients who will be treated with allopurinol.</p>