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

<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 asso...

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Main Authors: Lohitnavy Manupat, Saokaew Surasak, Eickman Elizabeth E, Somkrua Ratchadaporn, Chaiyakunapruk Nathorn
Format: Article
Language:English
Published: BMC 2011-09-01
Series:BMC Medical Genetics
Subjects:
Online Access:http://www.biomedcentral.com/1471-2350/12/118
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author Lohitnavy Manupat
Saokaew Surasak
Eickman Elizabeth E
Somkrua Ratchadaporn
Chaiyakunapruk Nathorn
author_facet Lohitnavy Manupat
Saokaew Surasak
Eickman Elizabeth E
Somkrua Ratchadaporn
Chaiyakunapruk Nathorn
author_sort Lohitnavy Manupat
collection DOAJ
description <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>
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spelling doaj.art-9104801503d444b592d892baeb673f462022-12-21T20:13:44ZengBMCBMC Medical Genetics1471-23502011-09-0112111810.1186/1471-2350-12-118Association of <it>HLA-B*5801 </it>allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysisLohitnavy ManupatSaokaew SurasakEickman Elizabeth ESomkrua RatchadapornChaiyakunapruk Nathorn<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>http://www.biomedcentral.com/1471-2350/12/118Human leukocyte antigensevere cutaneous reactionStevens-Johnson syndrometoxic epidermal necrolysisallopurinolmeta-analysis
spellingShingle Lohitnavy Manupat
Saokaew Surasak
Eickman Elizabeth E
Somkrua Ratchadaporn
Chaiyakunapruk Nathorn
Association of <it>HLA-B*5801 </it>allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis
BMC Medical Genetics
Human leukocyte antigen
severe cutaneous reaction
Stevens-Johnson syndrome
toxic epidermal necrolysis
allopurinol
meta-analysis
title Association of <it>HLA-B*5801 </it>allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis
title_full Association of <it>HLA-B*5801 </it>allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis
title_fullStr Association of <it>HLA-B*5801 </it>allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis
title_full_unstemmed Association of <it>HLA-B*5801 </it>allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis
title_short Association of <it>HLA-B*5801 </it>allele and allopurinol-induced stevens johnson syndrome and toxic epidermal necrolysis: a systematic review and meta-analysis
title_sort association of it hla b 5801 it allele and allopurinol induced stevens johnson syndrome and toxic epidermal necrolysis a systematic review and meta analysis
topic Human leukocyte antigen
severe cutaneous reaction
Stevens-Johnson syndrome
toxic epidermal necrolysis
allopurinol
meta-analysis
url http://www.biomedcentral.com/1471-2350/12/118
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