HLA Screening Could Reduce the Risk for Toxic Epidermal Necrolysis and Other Rashes

HLA-B*1502 screening may totally prevent carbamazepine-induced SJS-TEN in Chinese and South Asian populations; HLA-A*3101 screening may dramatically reduce SJS-TEN and other rash syndromes in patients with European or Japanese ancestry.

After allopurinol, carbamazepine is the second most commonly reported cause of the Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS-TEN) spectrum, a life-threatening disease. Three recent studies explored the value of HLA testing for preventing these reactions.

The need to screen for the HLA-B*1502 allele in Asian patients who will be treated with carbamazepine is at the top of “black-box” FDA warnings for this drug. Investigators in Taiwan followed their important discovery of this allele (see JW Dermatol Apr 28 2004) with a screening study. Among 4855 patients of Han Chinese descent who were screened before being prescribed carbamazepine, 372 were carriers of the allele and did not take carbamazepine. During a 2-month follow-up of …

Reviewing Author

Neil H. Shear, MD, FRCPC

HLA Screening Could Reduce the Risk for Toxic Epidermal Necrolysis and Other Rashes

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Reviewing Author