The Medical Letter on Drugs and Therapeutics
In Brief: Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome
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Med Lett Drugs Ther. 2008 Apr 21;50(1284):29
 Select a term to see related articles  2008   April 21   carbamazepine   Carbatrol   Equetro   Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome   genetic tests   In brief   Issue 1284   Page 32   SJS   stevens-johnson syndrome   Tegretol   volume 50 

Genetic Test for Carbamazepine-Induced Stevens-Johnson Syndrome Carbamazepine (Tegretol, Carbatrol, Equetro, and others), which is now used to treat not only epilepsy but also trigeminal neuralgia and manic episodes in patients with bipolar disorder,1 is a known cause of Stevens-Johnson syndrome (SJS). The incidence of carbamazepine-induced SJS in countries with mainly white populations is 1 to 6 per 10,000 new users of the drug, but Asian patients have a 10-fold higher incidence of this reaction. An association has been found between the human leukocyte antigen (HLA)-B*1502 allele and carbamazepine-induced SJS in a Chinese population.2 This allele occurs almost exclusively in Asians.3,4 The FDA is now recommending that Asian patients be tested for genetic susceptibility to carbamazepine-induced SJS before starting the drug. The genetic test should be available in most clinical chemistry labs.

1. Extended-release carbamazepine (Equetro) for bipolar disorder. Med Lett Drugs Ther 2005; 47:27.

2. WH Chung et al. Medical genetics: a marker for Stevens- Johnson syndrome. Nature 2004; 428:486.

3. C Lonjou et al. A marker for Stevens-Johnson syndrome. . . : ethnicity matters. Pharmacogenomics J 2006; 6:265.

4. A Alfirevic et al. HLA-B locus in Caucasian patients with carbamazepine hypersensitivity. Pharmacogenomics 2006; 7:813.

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