Dapsone-induced severe cutaneous adverse drug reactions are strongly linked with HLA-B13: 01 allele in the Thai population

• Published in: Pharmacogenetics and genomics Vol. 27; no. 12; p. 429
• Main Authors: Tempark, Therdpong, Satapornpong, Patompong, Rerknimitr, Pawinee, Nakkam, Nontaya, Saksit, Niwat, Wattanakrai, Penpun, Jantararoungtong, Thawinee, Koomdee, Napatrupron, Mahakkanukrauh, Ajanee, Tassaneeyakul, Wichittra, Suttisai, Sumitra, Pratoomwun, Jirawat, Klaewsongkram, Jettanong, Rerkpattanapipat, Ticha, Sukasem, Chonlaphat
• Format: Journal Article
• Language: English
• Published: United States 01.12.2017
• Subjects: Adult; Alleles; Case-Control Studies; Child, Preschool; Dapsone - adverse effects; Female; HLA-B Antigens - genetics; Humans; Leprostatic Agents - adverse effects; Male; Middle Aged; Skin - drug effects; Thailand; Young Adult
• DOI: 10.1097/FPC.0000000000000306

A previous publication in Chinese leprosy patients showed that the HLA-B*13:01 allele is a strong genetic marker for dapsone-induced drug hypersensitivity reactions, however there are no data describing whether HLA-B*13:01 is a valid marker for prediction of dapsone-induced drug hypersensitivity reactions in other ethnicities or nonleprosy patients. The aim of this study is to investigate whether there is an association between HLA genotypes and dapsone-induced severe cutaneous adverse reactions (SCARs) in Thai nonleprosy patients. HLA-B genotypes of 15 patients with dapsone-induced SCARs (11 drug reaction with eosinophilia and systemic symptoms, 4 Stevens-Johnson syndrome/toxic epidermal necrolysis), 29 control patients, and 986 subjects from the general Thai population were determined by the reverse PCR sequence-specific oligonucleotides probe. The HLA-B*13:01 allele was significantly associated with dapsone-induced SCARs compared with dapsone-tolerant controls (odds ratio: 54.00, 95% confidence interval: 7.96-366.16, P=0.0001) and the general population (odds ratio: 26.11, 95% confidence interval: 7.27-93.75, P=0.0001). In addition, HLA-B*13:01 associated with dapsone-induced SJS-TEN (OR: 40.50, 95% confidence interval: 2.78-591.01, P=0.0070) and DRESS (OR: 60.75, 95% confidence interval: 7.44-496.18, P=0.0001). This study demonstrated an association between HLA-B*13:01 and dapsone-induced SCARs including Stevens-Johnson syndrome/toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms in nonleprosy patients. Moreover, these results suggest that the HLA-B*13:01 allele may be a useful genetic marker for prediction of dapsone-induced SCARs in Thai and Han-Chinese populations.