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Sabourirad S, Mortezaee R, Mojarad M, et al. Investigating the association of Lamotrigine and Phenytoin-induced Stevens-Johnson syndrome/Toxic Epidermal Necrolysis with HLA-B*1502 in Iranian population. Exp Dermatol. 2020;30(2):284-287doi: 10.1111/exd.14240.
Sabourirad, S., Mortezaee, R., Mojarad, M., Eslahi, A., Shahrokhi, Y., Kiafar, B., Jarahi, L., Afkhami Ardakani, S., & Farrokhi, S. (2021). Investigating the association of Lamotrigine and Phenytoin-induced Stevens-Johnson syndrome/Toxic Epidermal Necrolysis with HLA-B*1502 in Iranian population. Experimental dermatology, 30(2), 284-287. https://doi.org/10.1111/exd.14240
Sabourirad, Sara, et al. "Investigating the association of Lamotrigine and Phenytoin-induced Stevens-Johnson syndrome/Toxic Epidermal Necrolysis with HLA-B*1502 in Iranian population." Experimental dermatology vol. 30,2 (2021): 284-287. doi: https://doi.org/10.1111/exd.14240
Sabourirad S, Mortezaee R, Mojarad M, Eslahi A, Shahrokhi Y, Kiafar B, Jarahi L, Afkhami Ardakani S, Farrokhi S. Investigating the association of Lamotrigine and Phenytoin-induced Stevens-Johnson syndrome/Toxic Epidermal Necrolysis with HLA-B*1502 in Iranian population. Exp Dermatol. 2021 Feb;30(2):284-287. doi: 10.1111/exd.14240. Epub 2020 Dec 04. PMID: 33217035.
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Exp Dermatol. 2021 Feb;30(2):284-287. doi: 10.1111/exd.14240. Epub 2020 Dec 04.

Investigating the association of Lamotrigine and Phenytoin-induced Stevens-Johnson syndrome/Toxic Epidermal Necrolysis with HLA-B*1502 in Iranian population.

Experimental dermatology

Sara Sabourirad, Reza Mortezaee, Majid Mojarad, Atieh Eslahi, Yahya Shahrokhi, Bita Kiafar, Lida Jarahi, Saman Afkhami Ardakani, Shima Farrokhi

Affiliations

  1. Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
  2. Dermatology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  3. Young Researchers and Elites Club, Islamic Azad University, Mashhad Branch, Mashhad, Iran.
  4. Genetic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
  5. Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  6. Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  7. Department of public health, Mashhad University of Medical Sciences, Mashhad, Iran.

PMID: 33217035 DOI: 10.1111/exd.14240

Abstract

Previous studies have found an association between HLA-B*1502 allele and lamotrigine-induced Stevens-Johnson syndrome (SJS)/ toxic epidermal necrosis (TEN) spectrum in Han Chinese populations. This study aims to investigate the association between HLA-B*1502 and lamotrigine- or phenytoin- induced SJS/TEN in an Iranian population. The medical records of twenty-eight lamotrigine-induced SJS/TEN patients and twenty-five lamotrigine-tolerant controls as well as eight phenytoin-induced SJS/TEN and twelve phenytoin-tolerant controls were extracted between March 2013 and March 2019 from the university hospitals in Mashhad, Iran. The presence of HLA-B*1502 allele was determined using real-time polymerase chain reaction (PCR). Among lamotrigine-induced patients with SJS/TEN, 11 (39.3%) patients tested positive for the HLA-B*1502 while only 3 (12.0%) of the lamotrigine-tolerant controls tested positive for this allele. The risk of lamotrigine-induced SJS/TEN was significantly higher in patients with HLA-B*1502, with an odds ratio (OR) of 4.74 [95% confidence interval (CI) 1.14-19.73, p = 0.032]. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HLA-B*1502 for lamotrigine-induced SJS/TEN was 39.29%, 88.00%, 78.57% and 56.41%, respectively. The HLA-B*1502 allele was present in 2 (25.0%) of phenytoin-induced SJS/TEN cases and 5 (41.7%) of the phenytoin-tolerant controls tested positive for HLA-B*1502 allele. The risk of phenytoin-induced SJS/TEN was not higher in the patients with HLA-B*1502 (OR = 0.467 [95% confidence interval (CI) 0.065-3.34, p = 0.642]). Lamotrigine-induced SJS/TEN is associated with HLA-B*1502 allele in an Iranian population but this is not the case for phenytoin-induced SJS/TEN.

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Keywords: HLA-B Antigens; Stevens-Johnson Syndrome; lamotrigine; pharmacogenetics; phenytoin

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