Genetic Susceptibility of Alleles to Non-Steroidal Anti-Inflammatory Drug Hypersensitivity in the Taiwanese Population.

Background: Human leukocyte antigen () genes are important in many immune processes and contribute to many adverse drug reactions. Whether genetic variations in the region are associated with non-steroid anti-inflammatory drug (NSAID) hypersensitivity remains uncertain. Therefore, the aim of our study was to identify genetic variations in patients with NSAID hypersensitivity in the Taiwanese population.

Methods: This hospital-based, retrospective case-control study enrolled 37,156 participants with NSAID exposure from the Taiwan Precision Medicine Initiative (TPMI), who were all genotyped and imputed to fine map typing. Our study assigned 1217 cases to the NSAID allergy group and 12,170 controls to a matched group. Logistic regression analyses were utilized to explore associations between alleles and NSAID hypersensitivity.

Results: Overall, 13,387 patients were genotyped for eight major alleles. Allele frequencies were different between the two groups. In the NSAID allergy group, the genotype frequencies of , , and were found to be markedly elevated compared to the control group, a significance that persisted even after applying the Bonferroni correction. Furthermore, the risk of NSAID allergy demonstrated a significant association with (OR = 1.29, < 0.001) and (OR = 9.90, = 0.001), in comparison to their respective counterparts. Notably, the genotype frequency of exhibited a significant increase in the severe allergy group when compared with the mild allergy group.

Conclusions: We identified genotypes linked to the onset and severity of NSAID hypersensitivity. Our findings establish a basis for precision prescription in future clinical applications.