Risk factors of allopurinol-induced severe cutaneous adverse reactions in a Thai population

Pharmacogenetics and Genomics
Niwat SaksitWongwiwat Tassaneeyakul

Abstract

Allopurinol is one of the most common causes of severe cutaneous adverse drug reactions (SCARs) including drug reactions with eosinophilia and systemic symptoms (DRESS), Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). This study identified the risk factors associated with the development of allopurinol-induced SCARs in a Thai population. Eighty-six allopurinol-induced SCARs (i.e. 19 DRESS and 67 SJS/TEN) and 182 allopurinol-tolerant patients were enrolled in the study. The HLA-B*58:01 allele was determined. Clinical and medicinal data were collected. Results from multivariate analysis showed that only the HLA-B*58:01 and female sex were identified as risk factors of allopurinol-induced SCARs in this Thai population. Patients who carried the HLA-B*58:01 allele were at a higher risk of allopurinol-induced DRESS [odds ratio (OR)=149.2, 95% confidence interval (CI)=24.0-∞, P<1.00×10]. Similar results were observed in allopurinol-induced SJS/TEN (OR=175.0, 95% CI=44.3-690.9, P=1.69×10). The risk of allopurinol-induced SCARs in women was higher than that in men (OR=4.6, 95% CI=1.4-15.6, P=1.44×10). The overall mortality rate of allopurinol-induced SCARs was 11.39% and a higher mortality rate was observed in elde...Continue Reading

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Citations

Mar 7, 2020·Pharmacoepidemiology and Drug Safety·Chonlaphat SukasemSuvatna Chulavatnatol
Jun 9, 2020·Expert Opinion on Drug Metabolism & Toxicology·Wan-Chun ChangWen-Hung Chung
Jan 5, 2021·Therapeutic Innovation & Regulatory Science·Sing Chet LeeVidhya Hariraj
Jun 8, 2021·Drug Metabolism and Pharmacokinetics·Chonlaphat SukasemNapatrupron Koomdee

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