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Departments of aPediatrics, Division of Pediatric Dermatology bMedicine, Division of Dermatology, Skin and Allergy Research Unit cMedicine, Division of Allergy and Clinical Immunology, Skin and Allergy Research Unit, Faculty of Medicine, Chulalongkorn University dLaboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC) eDepartment of Pathology, Division of Pharmacogenomics and Personalized Medicine fDepartment of Medicine, Division of Dermatology gDepartment of Medicine, Division of Allergy Immunology and Rheumatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University hThe Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group, Bangkok Departments of iPharmacology jMedicine, Faculty of Medicine, Khon Kaen University, Khon Kaen kSchool of Pharmaceutical Sciences, University of Phayao, Phayao lPharmacy Department, Phrae Hospital, Phrae, Thailand.
Published: December 2017
AI Article Synopsis
Article Abstract
Objectives: A previous publication in Chinese leprosy patients showed that the HLA-B*13:01 allele is a strong genetic marker for dapsone-induced drug hypersensitivity reactions, however there are no data describing whether HLA-B*13:01 is a valid marker for prediction of dapsone-induced drug hypersensitivity reactions in other ethnicities or nonleprosy patients. The aim of this study is to investigate whether there is an association between HLA genotypes and dapsone-induced severe cutaneous adverse reactions (SCARs) in Thai nonleprosy patients.
Patients And Methods: HLA-B genotypes of 15 patients with dapsone-induced SCARs (11 drug reaction with eosinophilia and systemic symptoms, 4 Stevens-Johnson syndrome/toxic epidermal necrolysis), 29 control patients, and 986 subjects from the general Thai population were determined by the reverse PCR sequence-specific oligonucleotides probe.
Results: The HLA-B*13:01 allele was significantly associated with dapsone-induced SCARs compared with dapsone-tolerant controls (odds ratio: 54.00, 95% confidence interval: 7.96-366.16, P=0.0001) and the general population (odds ratio: 26.11, 95% confidence interval: 7.27-93.75, P=0.0001). In addition, HLA-B*13:01 associated with dapsone-induced SJS-TEN (OR: 40.50, 95% confidence interval: 2.78-591.01, P=0.0070) and DRESS (OR: 60.75, 95% confidence interval: 7.44-496.18, P=0.0001).
Conclusion: This study demonstrated an association between HLA-B*13:01 and dapsone-induced SCARs including Stevens-Johnson syndrome/toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms in nonleprosy patients. Moreover, these results suggest that the HLA-B*13:01 allele may be a useful genetic marker for prediction of dapsone-induced SCARs in Thai and Han-Chinese populations.
