HLA-B*1502 Strongly Predicts Carbamazepine-Induced Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Thai Patients with Neuropathic Pain

摘要: Background:  Carbamazepine (CBZ) is one of the standard pharmacological treatments for neuropathic pain. However, its serious adverse drug reactions include Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Recently, HLA-B*1502 allele was implicated as a genetic marker CBZ-induced SJS/TEN in some Asian epilepsy populations. Methods:  This case control study to describe clinical characteristics Thai patients with pain who were treated CBZ, determine association these patients, comparing those exposed CBZ at least 6 months without any cutaneous reactions. Results:  Thirty-four 40 included this study. Mean age 47 years. developed 10.8 ± 1.4 days after initiation CBZ. found 32 34 (94.1%) but it only 7 (17.5%). The very strong an odds ratio 75.4. Sensitivity specificity genotype test 94.1% 82.5%, respectively, while positive predictive value negative 1.43% 99.98%, respectively. Positive likelihood ratios 5.37 0.07, respectively. Conclusions: HLA-B*1502 screening should be performed prior treatment assess risk side effect.