This study demonstrated population differences in the risk of allopurinol-related SCAR development among East Asians based on genetic and other common risk factors. The IRRs were higher in patients with chronic kidney disease, females, and elderly. This order was accordant with that of AF ratios (AFRs) reported of HLA- B*58: 01 against alleles responsible for phenytoin- or carbamazepine-related SCARs. The crude incidence rate ratios (IRRs) of SCARs for allopurinol against phenytoin or carbamazepine were the highest in Taiwan (IRR, 0.62 and 1.22 95% confidence interval, 0.54–0.72 and 1.01–1.47, respectively), followed by Korea (IRR, 0.34 and 0.82 95% CI, 0.29–0.40 and 0.77–0.87), and the lowest in Japan (IRR, 0.04 and 0.16 95% CI, 0.02–0.08 and 0.09–0.29). As control drugs, phenytoin and carbamazepine were used. New users of allopurinol (311,846 868,221 and 18,052 in Taiwan, Korea, and Japan, respectively) were followed up to 1 year. A population-based cohort study was conducted using claims databases from Taiwan, Korea, and Japan. This study aimed to evaluate population differences in allopurinol-related SCAR incidence related to genetic and/or other risk factors among East Asians in the real-world.
However, evidence of population differences in SCAR development and relevance of genetic and/or other risk factors in the real-world remain unelucidated. Allopurinol-related severe cutaneous adverse reactions (SCARs) are strongly associated with HLA- B*58: 01, the allele frequency (AF) of which is largely different among East Asians.
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