Question 2 Should phenytoin and carbamazepine be avoided in Asian populations with the HLA-B*1502 positive genetic variant?

摘要

R ecently, Drug Safety Update (a monthly newsletter from the Medicines and Healthcare products Regulatory Agency (MHRA) and the UK Commission on Human Medicines) issued an alert on the antiepileptic drug (AED) phenytoin (PHT) regarding an increased risk of Steven–Johnson syndrome (SJS) associated with the presence of the HLA-B*1502 genetic variant in patients of Asian origin. Likewise, the US Federal Drug Agency (FDA) recommended genotyping for the allele in all Asian patients before starting carbamazepine (CBZ). We wanted to explore the implications of this for our clinical practice.