@article{4c57a4b3a75040b18e3bc6a4b23f489a,
title = " Efficacy of the HLA-B ∗ 58:01 Screening Test in Preventing Allopurinol-Induced Severe Cutaneous Adverse Reactions in Patients with Chronic Renal Insufficiency—A Prospective Study ",
abstract = " Background: Thus far, human leukocyte antigen (HLA)-B ∗ 58:01 has been recognized as the most important risk factor for allopurinol induced severe cutaneous adverse reactions (SCARs). Objective: To determine the usefulness of prospective screening for the HLA-B ∗ 58:01 allele to identify Korean individuals at risk for SCARs induced by allopurinol treatment. Methods: We prospectively enrolled 542 patients with chronic renal insufficiency (CRI) from 10 hospitals nationwide and performed DNA genotyping to determine whether they carried the HLA-B ∗ 58:01 allele. Of these, 503 HLA-B ∗ 58:01-negative patients (92.8% of total) were treated with allopurinol, and 39 HLA-B ∗ 58:01-positive patients (7.2%) were treated with febuxostat, an alternative drug. The patients then were followed up biweekly for 90 days using a telephone survey to monitor symptoms of adverse drug reactions, including SCARs. As a control, we used the historical incidence rate of allopurinol-induced SCARs in 4002 patients with CRI from the same hospitals who were enrolled retrospectively. Results: Nineteen patients in the prospective cohort developed mild and transient adverse reactions but none showed allopurinol-induced SCARs. By contrast, we identified 38 patients with allopurinol-induced SCARs (0.95%) in the historical control. The difference in the incidence of allopurinol-induced SCARs between the prospective cohort and historical control was statistically significant (0% vs 0.95%, respectively; P =.029). Conclusions: The present study demonstrated the clinical usefulness of the HLA-B ∗ 58:01 screening test before allopurinol administration to prevent allopurinol-induced SCARs in patients with CRI.",
keywords = "Allopurinol, Chronic, Drug hypersensitivity, HLA-B 58:01 allele, Renal insufficiency",
author = "Park, {Heung Woo} and Kim, {Dong Ki} and Kim, {Sae Hoon} and Sejoong Kim and Chae, {Dong Wan} and Yang, {Min Suk} and Oh, {Yun Kyu} and Lee, {Jung Pyo} and Jung, {Jae Woo} and Jungho Shin and Hwang, {Jin Ho} and Kang, {Min Gyu} and Kim, {Sun Moon} and Kwon, {Soon Kil} and Kim, {Hye Young} and Kim, {Min Hye} and Kim, {Seung Jung} and Ryu, {Dong Ryeol} and Cho, {Young Joo} and Jee, {Young Koo} and Kim, {So Mi} and Lee, {Eun Kyoung} and Kim, {Ju Young} and Cho, {Hyun Seop} and Jeong, {Yi Yeong} and Kim, {Sang Heon} and Jun, {Jae Bum} and Park, {Joon Sung} and Kim, {Gheun Ho} and Sujeong Kim and Jung, {Hee Yeon} and Lee, {Jong Myung}",
note = "Funding Information: This research was supported by a grant ( 15182MFDS506 ) from Ministry of Food and Drug Safety in 2016 and 2017. Funding Information: This research was supported by a grant (15182MFDS506) from Ministry of Food and Drug Safety in 2016 and 2017. This research was supported by a grant (15182MFDS506) from Ministry of Food and Drug Safety in 2016 and 2017. The authors wish to acknowledge and thank all of the clinical research coordinators from each hospital: Su-Jung Kim (Seoul National University Hospital), Hye-Su Jeong (Seoul National University Hospital), Hyeon-Ji Woo (Seoul National University Bundang Hospital), Yena Ahn (Seoul National University Bundang Hospital), Young-Ju Kim (Seoul National University Boramae Medical Center), Hye Ryeon Song (Chug-Ang University Hospital), Hyang Ran Kim (Ewha Womans University Hospital), Jongsoon Lee (Dankook University Hospital), Eunsil Han (Dankook University Hospital), Jieun Jang (Gyeongsang National University Hospital), Youn-jeong Mun (Hanyang University Hospital), and Yaelee Jang (Kyungpook National University Hospital). This research was supported by a grant (15182MFDS506) from Ministry of Food and Drug Safety in 2016 and 2017. Publisher Copyright: {\textcopyright} 2018 American Academy of Allergy, Asthma & Immunology",
year = "2019",
month = apr,
doi = "10.1016/j.jaip.2018.12.012",
language = "English",
volume = "7",
pages = "1271--1276",
journal = "Journal of Allergy and Clinical Immunology: In Practice",
issn = "2213-2198",
publisher = "Elsevier",
number = "4",
}