Heliyon
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, USM Pulau Pinang, Malaysia.
Published: January 2025
Introduction: Severe cutaneous adverse reactions (SCARs) are life-threatening and often linked to antiepileptic drugs (AEDs). Common types of SCARs include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Immune-mediated mechanisms involving human leukocyte antigen () alleles have been implicated in the pathogenesis of this reaction. This study examines the association between specific alleles (, and -) and AED-induced SCARs in the Iraqi population.
Methodology: A total of 50 patients diagnosed with SCARs and 90 tolerant controls were recruited from Dr. Saad Al-Wattari Hospital for Neurological Sciences and Baghdad Hospital - Medical City. genotyping was performed using PCR-SSO method from peripheral blood samples. Statistical comparisons were made using the -test or chi-square test, while univariate logistic regression with Bonferroni's correction (p < 0.05) were used to assess associations between alleles and SCARs.
Results: Among the patients, SJS was the most prevalent type of SCARs observed. Analysis of allele frequencies revealed significant associations between specific alleles. was found to be significantly associated with a lower risk of AED-induced SJS (OR = 0.36; 95 % CI: 0.13-0.97), while and were associated with an increased risk of AED-induced SJS (OR = 3.60; 95 % CI: 1.21-10.72 and OR = 4.41; 95 % CI: 1.18-16.47, respectively). For AED-induced TEN, , and showed significant associations (OR = 6.92; 95 % CI: 1.39-34.37 and OR = 6.55; 95 % CI: 1.62-26.52, respectively), with being highly significant (OR = 5.09; 95 % CI: 1.72-15.00). Additionally, was strongly associated with AED-induced DRESS (OR = 29.33; 95 % CI: 3.50-245.32).
Conclusion: This study identifies key alleles associated with AED-induced SCARs in the Iraqi population. These findings could facilitate personalized medicine approaches, aiding in better prediction and prevention of SCARs in AED therapy.
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http://dx.doi.org/10.1016/j.heliyon.2024.e41108 | DOI Listing |
Heliyon
January 2025
Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, USM Pulau Pinang, Malaysia.
Introduction: Severe cutaneous adverse reactions (SCARs) are life-threatening and often linked to antiepileptic drugs (AEDs). Common types of SCARs include Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Immune-mediated mechanisms involving human leukocyte antigen () alleles have been implicated in the pathogenesis of this reaction.
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