An effective strategy to prevent allopurinol-induced hypersensitivity by HLA typing
Purpose: This study was conducted to evaluate the usefulness of human leukocyte antigen (HLA) typing in preventing allopurinol-induced severe cutaneous adverse reactions (SCARs) through the application of an allopurinol tolerance induction protocol or prescription of other alternative medications in...
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| Veröffentlicht in: | Genetics in medicine 2015-10, Vol.17 (10), p.807-814 |
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| creator | Jung, Jae-Woo Kim, Dong-Ki Park, Heung-Woo Oh, Kook-Hwan Joo, Kwon-Wook Kim, Yon-Su Ahn, Curie Lee, Kyung Wha Cho, Sang-Heon Min, Kyung-Up Kang, Hye-Ryun |
| description | Purpose:
This study was conducted to evaluate the usefulness of human leukocyte antigen (HLA) typing in preventing allopurinol-induced severe cutaneous adverse reactions (SCARs) through the application of an allopurinol tolerance induction protocol or prescription of other alternative medications in high-risk patients.
Methods:
HLA typing was performed in patients with chronic renal insufficiency who needed allopurinol. HLA-B*58:01-negative patients were prescribed the usual dose of allopurinol. For HLA-B*58:01-positive patients, administration of either allopurinol based on a 28-day tolerance induction protocol or alternative medications was initiated. Hypersensitivity reactions were surveyed for 90 days and compared with the result of a previous retrospective cohort study.
Results:
Among a total of 401 study subjects, no SCARs were noted in HLA-B*58:01-positive patients with application of the tolerance induction protocol (
n
= 30) or alternative medications (
n
= 16), nor were any SCARs observed in HLA-B*58:01-negative patients who started allopurinol at the usual dose (
n
= 355). Compared with the previous retrospective cohort study, a significant reduction in SCARs was observed in HLA-B*58:01-positive patients (0 vs. 18%;
P
= 0.002).
Conclusion:
This study shows the usefulness of HLA-B*58:01 screening in identifying patients at high risk for the development of allopurinol-induced SCARs and suggests that application of a tolerance induction protocol or alternative medications could be an effective strategy to prevent allopurinol-induced SCARs in HLA-B*58:01-positive patients.
Genet Med
17
10, 807–814. |
| doi_str_mv | 10.1038/gim.2014.195 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_1844715262</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4265484531</sourcerecordid><originalsourceid>FETCH-LOGICAL-c423t-337efbe3226884bbb73fa58d320f38f113d34e1bcc095c1544c7d3f83054956c3</originalsourceid><addsrcrecordid>eNptkNFLwzAQh4MoTqdvPkvAVzuTXNJ2j2OoEwY-qM-lTS-1o2trkg7635uxKT74dAf33e-Oj5AbzmacQfpQ1duZYFzO-FydkAuugEUM4vg09GyeRhAzNiGXzm0Y4wkIdk4mQsUgmZAX5G3RUjQGta93SJ23ucdqpL6jvcUdtp7mTdP1g63bronqthw0lvRz7NE6bF0d1mo_0mKkq_WC-rGv2-qKnJm8cXh9rFPy8fT4vlxF69fnl-ViHWkpwEcACZoCQYg4TWVRFAmYXKVleNFAajiHEiTyQms2V5orKXVSgkmBKTlXsYYpuTvk9rb7GtD5bNMNtg0nM55KmXAlYhGo-wOlbeecRZP1tt7mdsw4y_YGs2Aw2xvMgsGA3x5Dh2KL5S_8oywA0QFwYdRWaP9c_S_wG5Juevk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1844715262</pqid></control><display><type>article</type><title>An effective strategy to prevent allopurinol-induced hypersensitivity by HLA typing</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Jung, Jae-Woo ; Kim, Dong-Ki ; Park, Heung-Woo ; Oh, Kook-Hwan ; Joo, Kwon-Wook ; Kim, Yon-Su ; Ahn, Curie ; Lee, Kyung Wha ; Cho, Sang-Heon ; Min, Kyung-Up ; Kang, Hye-Ryun</creator><creatorcontrib>Jung, Jae-Woo ; Kim, Dong-Ki ; Park, Heung-Woo ; Oh, Kook-Hwan ; Joo, Kwon-Wook ; Kim, Yon-Su ; Ahn, Curie ; Lee, Kyung Wha ; Cho, Sang-Heon ; Min, Kyung-Up ; Kang, Hye-Ryun</creatorcontrib><description>Purpose:
This study was conducted to evaluate the usefulness of human leukocyte antigen (HLA) typing in preventing allopurinol-induced severe cutaneous adverse reactions (SCARs) through the application of an allopurinol tolerance induction protocol or prescription of other alternative medications in high-risk patients.
Methods:
HLA typing was performed in patients with chronic renal insufficiency who needed allopurinol. HLA-B*58:01-negative patients were prescribed the usual dose of allopurinol. For HLA-B*58:01-positive patients, administration of either allopurinol based on a 28-day tolerance induction protocol or alternative medications was initiated. Hypersensitivity reactions were surveyed for 90 days and compared with the result of a previous retrospective cohort study.
Results:
Among a total of 401 study subjects, no SCARs were noted in HLA-B*58:01-positive patients with application of the tolerance induction protocol (
n
= 30) or alternative medications (
n
= 16), nor were any SCARs observed in HLA-B*58:01-negative patients who started allopurinol at the usual dose (
n
= 355). Compared with the previous retrospective cohort study, a significant reduction in SCARs was observed in HLA-B*58:01-positive patients (0 vs. 18%;
P
= 0.002).
Conclusion:
This study shows the usefulness of HLA-B*58:01 screening in identifying patients at high risk for the development of allopurinol-induced SCARs and suggests that application of a tolerance induction protocol or alternative medications could be an effective strategy to prevent allopurinol-induced SCARs in HLA-B*58:01-positive patients.
Genet Med
17
10, 807–814.</description><identifier>ISSN: 1098-3600</identifier><identifier>EISSN: 1530-0366</identifier><identifier>DOI: 10.1038/gim.2014.195</identifier><identifier>PMID: 25634024</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>631/208/2489/1512 ; 692/699/1585 ; 692/699/249 ; 692/700/565/1436/434 ; Adult ; Aged ; Alleles ; Allopurinol - administration & dosage ; Allopurinol - adverse effects ; Biomedicine ; Desensitization, Immunologic ; Drug Hypersensitivity - diagnosis ; Drug Hypersensitivity - epidemiology ; Drug Hypersensitivity - genetics ; Drug Hypersensitivity - immunology ; Drug Hypersensitivity - prevention & control ; Female ; Histocompatibility Antigens - genetics ; Histocompatibility Antigens - immunology ; Histocompatibility Testing ; HLA-B Antigens - genetics ; HLA-B Antigens - immunology ; Human Genetics ; Humans ; Immune Tolerance ; Incidence ; Laboratory Medicine ; Male ; Middle Aged ; original-research-article ; Risk Factors</subject><ispartof>Genetics in medicine, 2015-10, Vol.17 (10), p.807-814</ispartof><rights>American College of Medical Genetics and Genomics 2015</rights><rights>Copyright Nature Publishing Group Oct 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c423t-337efbe3226884bbb73fa58d320f38f113d34e1bcc095c1544c7d3f83054956c3</citedby><cites>FETCH-LOGICAL-c423t-337efbe3226884bbb73fa58d320f38f113d34e1bcc095c1544c7d3f83054956c3</cites><orcidid>0000-0002-2317-4201</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25634024$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Jae-Woo</creatorcontrib><creatorcontrib>Kim, Dong-Ki</creatorcontrib><creatorcontrib>Park, Heung-Woo</creatorcontrib><creatorcontrib>Oh, Kook-Hwan</creatorcontrib><creatorcontrib>Joo, Kwon-Wook</creatorcontrib><creatorcontrib>Kim, Yon-Su</creatorcontrib><creatorcontrib>Ahn, Curie</creatorcontrib><creatorcontrib>Lee, Kyung Wha</creatorcontrib><creatorcontrib>Cho, Sang-Heon</creatorcontrib><creatorcontrib>Min, Kyung-Up</creatorcontrib><creatorcontrib>Kang, Hye-Ryun</creatorcontrib><title>An effective strategy to prevent allopurinol-induced hypersensitivity by HLA typing</title><title>Genetics in medicine</title><addtitle>Genet Med</addtitle><addtitle>Genet Med</addtitle><description>Purpose:
This study was conducted to evaluate the usefulness of human leukocyte antigen (HLA) typing in preventing allopurinol-induced severe cutaneous adverse reactions (SCARs) through the application of an allopurinol tolerance induction protocol or prescription of other alternative medications in high-risk patients.
Methods:
HLA typing was performed in patients with chronic renal insufficiency who needed allopurinol. HLA-B*58:01-negative patients were prescribed the usual dose of allopurinol. For HLA-B*58:01-positive patients, administration of either allopurinol based on a 28-day tolerance induction protocol or alternative medications was initiated. Hypersensitivity reactions were surveyed for 90 days and compared with the result of a previous retrospective cohort study.
Results:
Among a total of 401 study subjects, no SCARs were noted in HLA-B*58:01-positive patients with application of the tolerance induction protocol (
n
= 30) or alternative medications (
n
= 16), nor were any SCARs observed in HLA-B*58:01-negative patients who started allopurinol at the usual dose (
n
= 355). Compared with the previous retrospective cohort study, a significant reduction in SCARs was observed in HLA-B*58:01-positive patients (0 vs. 18%;
P
= 0.002).
Conclusion:
This study shows the usefulness of HLA-B*58:01 screening in identifying patients at high risk for the development of allopurinol-induced SCARs and suggests that application of a tolerance induction protocol or alternative medications could be an effective strategy to prevent allopurinol-induced SCARs in HLA-B*58:01-positive patients.
Genet Med
17
10, 807–814.</description><subject>631/208/2489/1512</subject><subject>692/699/1585</subject><subject>692/699/249</subject><subject>692/700/565/1436/434</subject><subject>Adult</subject><subject>Aged</subject><subject>Alleles</subject><subject>Allopurinol - administration & dosage</subject><subject>Allopurinol - adverse effects</subject><subject>Biomedicine</subject><subject>Desensitization, Immunologic</subject><subject>Drug Hypersensitivity - diagnosis</subject><subject>Drug Hypersensitivity - epidemiology</subject><subject>Drug Hypersensitivity - genetics</subject><subject>Drug Hypersensitivity - immunology</subject><subject>Drug Hypersensitivity - prevention & control</subject><subject>Female</subject><subject>Histocompatibility Antigens - genetics</subject><subject>Histocompatibility Antigens - immunology</subject><subject>Histocompatibility Testing</subject><subject>HLA-B Antigens - genetics</subject><subject>HLA-B Antigens - immunology</subject><subject>Human Genetics</subject><subject>Humans</subject><subject>Immune Tolerance</subject><subject>Incidence</subject><subject>Laboratory Medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>original-research-article</subject><subject>Risk Factors</subject><issn>1098-3600</issn><issn>1530-0366</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkNFLwzAQh4MoTqdvPkvAVzuTXNJ2j2OoEwY-qM-lTS-1o2trkg7635uxKT74dAf33e-Oj5AbzmacQfpQ1duZYFzO-FydkAuugEUM4vg09GyeRhAzNiGXzm0Y4wkIdk4mQsUgmZAX5G3RUjQGta93SJ23ucdqpL6jvcUdtp7mTdP1g63bronqthw0lvRz7NE6bF0d1mo_0mKkq_WC-rGv2-qKnJm8cXh9rFPy8fT4vlxF69fnl-ViHWkpwEcACZoCQYg4TWVRFAmYXKVleNFAajiHEiTyQms2V5orKXVSgkmBKTlXsYYpuTvk9rb7GtD5bNMNtg0nM55KmXAlYhGo-wOlbeecRZP1tt7mdsw4y_YGs2Aw2xvMgsGA3x5Dh2KL5S_8oywA0QFwYdRWaP9c_S_wG5Juevk</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Jung, Jae-Woo</creator><creator>Kim, Dong-Ki</creator><creator>Park, Heung-Woo</creator><creator>Oh, Kook-Hwan</creator><creator>Joo, Kwon-Wook</creator><creator>Kim, Yon-Su</creator><creator>Ahn, Curie</creator><creator>Lee, Kyung Wha</creator><creator>Cho, Sang-Heon</creator><creator>Min, Kyung-Up</creator><creator>Kang, Hye-Ryun</creator><general>Nature Publishing Group US</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><orcidid>https://orcid.org/0000-0002-2317-4201</orcidid></search><sort><creationdate>20151001</creationdate><title>An effective strategy to prevent allopurinol-induced hypersensitivity by HLA typing</title><author>Jung, Jae-Woo ; Kim, Dong-Ki ; Park, Heung-Woo ; Oh, Kook-Hwan ; Joo, Kwon-Wook ; Kim, Yon-Su ; Ahn, Curie ; Lee, Kyung Wha ; Cho, Sang-Heon ; Min, Kyung-Up ; Kang, Hye-Ryun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c423t-337efbe3226884bbb73fa58d320f38f113d34e1bcc095c1544c7d3f83054956c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>631/208/2489/1512</topic><topic>692/699/1585</topic><topic>692/699/249</topic><topic>692/700/565/1436/434</topic><topic>Adult</topic><topic>Aged</topic><topic>Alleles</topic><topic>Allopurinol - administration & dosage</topic><topic>Allopurinol - adverse effects</topic><topic>Biomedicine</topic><topic>Desensitization, Immunologic</topic><topic>Drug Hypersensitivity - diagnosis</topic><topic>Drug Hypersensitivity - epidemiology</topic><topic>Drug Hypersensitivity - genetics</topic><topic>Drug Hypersensitivity - immunology</topic><topic>Drug Hypersensitivity - prevention & control</topic><topic>Female</topic><topic>Histocompatibility Antigens - genetics</topic><topic>Histocompatibility Antigens - immunology</topic><topic>Histocompatibility Testing</topic><topic>HLA-B Antigens - genetics</topic><topic>HLA-B Antigens - immunology</topic><topic>Human Genetics</topic><topic>Humans</topic><topic>Immune Tolerance</topic><topic>Incidence</topic><topic>Laboratory Medicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>original-research-article</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Jae-Woo</creatorcontrib><creatorcontrib>Kim, Dong-Ki</creatorcontrib><creatorcontrib>Park, Heung-Woo</creatorcontrib><creatorcontrib>Oh, Kook-Hwan</creatorcontrib><creatorcontrib>Joo, Kwon-Wook</creatorcontrib><creatorcontrib>Kim, Yon-Su</creatorcontrib><creatorcontrib>Ahn, Curie</creatorcontrib><creatorcontrib>Lee, Kyung Wha</creatorcontrib><creatorcontrib>Cho, Sang-Heon</creatorcontrib><creatorcontrib>Min, Kyung-Up</creatorcontrib><creatorcontrib>Kang, Hye-Ryun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>Genetics in medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Jae-Woo</au><au>Kim, Dong-Ki</au><au>Park, Heung-Woo</au><au>Oh, Kook-Hwan</au><au>Joo, Kwon-Wook</au><au>Kim, Yon-Su</au><au>Ahn, Curie</au><au>Lee, Kyung Wha</au><au>Cho, Sang-Heon</au><au>Min, Kyung-Up</au><au>Kang, Hye-Ryun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An effective strategy to prevent allopurinol-induced hypersensitivity by HLA typing</atitle><jtitle>Genetics in medicine</jtitle><stitle>Genet Med</stitle><addtitle>Genet Med</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>17</volume><issue>10</issue><spage>807</spage><epage>814</epage><pages>807-814</pages><issn>1098-3600</issn><eissn>1530-0366</eissn><abstract>Purpose:
This study was conducted to evaluate the usefulness of human leukocyte antigen (HLA) typing in preventing allopurinol-induced severe cutaneous adverse reactions (SCARs) through the application of an allopurinol tolerance induction protocol or prescription of other alternative medications in high-risk patients.
Methods:
HLA typing was performed in patients with chronic renal insufficiency who needed allopurinol. HLA-B*58:01-negative patients were prescribed the usual dose of allopurinol. For HLA-B*58:01-positive patients, administration of either allopurinol based on a 28-day tolerance induction protocol or alternative medications was initiated. Hypersensitivity reactions were surveyed for 90 days and compared with the result of a previous retrospective cohort study.
Results:
Among a total of 401 study subjects, no SCARs were noted in HLA-B*58:01-positive patients with application of the tolerance induction protocol (
n
= 30) or alternative medications (
n
= 16), nor were any SCARs observed in HLA-B*58:01-negative patients who started allopurinol at the usual dose (
n
= 355). Compared with the previous retrospective cohort study, a significant reduction in SCARs was observed in HLA-B*58:01-positive patients (0 vs. 18%;
P
= 0.002).
Conclusion:
This study shows the usefulness of HLA-B*58:01 screening in identifying patients at high risk for the development of allopurinol-induced SCARs and suggests that application of a tolerance induction protocol or alternative medications could be an effective strategy to prevent allopurinol-induced SCARs in HLA-B*58:01-positive patients.
Genet Med
17
10, 807–814.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>25634024</pmid><doi>10.1038/gim.2014.195</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2317-4201</orcidid></addata></record> |
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| ispartof | Genetics in medicine, 2015-10, Vol.17 (10), p.807-814 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | 631/208/2489/1512 692/699/1585 692/699/249 692/700/565/1436/434 Adult Aged Alleles Allopurinol - administration & dosage Allopurinol - adverse effects Biomedicine Desensitization, Immunologic Drug Hypersensitivity - diagnosis Drug Hypersensitivity - epidemiology Drug Hypersensitivity - genetics Drug Hypersensitivity - immunology Drug Hypersensitivity - prevention & control Female Histocompatibility Antigens - genetics Histocompatibility Antigens - immunology Histocompatibility Testing HLA-B Antigens - genetics HLA-B Antigens - immunology Human Genetics Humans Immune Tolerance Incidence Laboratory Medicine Male Middle Aged original-research-article Risk Factors |
| title | An effective strategy to prevent allopurinol-induced hypersensitivity by HLA typing |
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