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HLA‐B*5801: utility and cost‐effectiveness in the A sia‐ P acific R egion
Author(s) -
Yeo Siaw Ing
Publication year - 2013
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.12050
Subject(s) - allopurinol , toxic epidermal necrolysis , medicine , human leukocyte antigen , pharmacogenomics , gout , immunology , antigen , pharmacology , dermatology
Gout is a common condition which is mainly treated with the hypo‐uricemic agent, allopurinol. Although allopurinol is generally a well‐tolerated drug, there is a small risk of developing potentially fatal complications, such as allopurinol hypersensitivity syndrome. Recent advances in pharmacogenomics have made possible the identification of genes which confer susceptibility to specific drugs. A recent multi‐national case‐control study has reported allopurinol as the most common drug associated with Stevens‐Johnson syndrome and toxic epidermal necrolysis. Several studies have established a strong association between the human leukocyte antigen ( HLA )‐B*5801 gene and development of Stevens‐Johnson syndrome and toxic epidermal necrolysis. The allele frequency of HLA ‐B*5801 is highest in the South East Asian population.Since other hypo‐uricemic agents are available, patients may wish to have HLA ‐B*5801 testing before being started on allopurinol. As the test for HLA ‐B*5801 is expensive, time‐consuming and only available in selected laboratories, there is a need to evaluate the utility and cost‐effectiveness of this test in our region.