Utility of human leukocyte antigen-B*58: 01 genotyping and patient outcomes.
Pharmacogenet Genomics
; 29(1): 1-8, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30379713
ABSTRACT
AIM:
Human leukocyte antigen (HLA-B*5801) allele screening before allopurinol administration is recommended to prevent gene-mediated severe cutaneous adverse reactions (SCARs). The objective of the analysis was to examine the clinical utility and effects of HLA-B*5801 genotyping on patient's outcomes in a practice setting. PATIENTS ANDMETHODS:
The electronic medical records covering diagnosis, laboratory results, and prescription dispensing for patients who were newly treated with allopurinol or tested for HLA-B*5801 were obtained from a large medical organization in Taiwan between 2010 and 2014. The uptake of HLA-B*5801 testing, incidence of allopurinol-associated SCAR, and changes in urate-lowering agent utilization were assessed.RESULTS:
A total of 17 532 allopurinol new users were identified from 2010 to 2014, and the HLA-B*5801 test was ordered for 2844 (21.76%) of 13 069 new users when available between 2011 and 2014 in the study. The allopurinol-related SCAR events decreased from 0.21% (22/4460) to 0 (0/2167) after the introduction of HLA-B*5801 testing, accompanied by a gradual increase from 8% (326/4207) to 31% (674/2167) in genotype testing rate. However, the HLA-B*5801 testing performed before allopurinol prescription was 60.34%, and ~40% of patients were tested after already taking allopurinol. A shift from allopurinol to other urate-lowering agent regimens appeared among new allopurinol users.CONCLUSION:
HLA-B*5801 test was associated with the prevention of allopurinol-induced SCAR. The clinical utility of genotype testing may not be consistent with recommendations for testing, and treatment alternatives are a competitive intervention associated with effective implications in a real-world setting.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Antígenos HLA-B
/
Alopurinol
/
Toxidermias
/
Técnicas de Genotipagem
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article