Carbamazepine, an anticonvulsant and a mood-stabilizing drug, is the main cause of the Stevens-Johnson syndrome (SJS) and its related disease, toxic epidermal necrolysis (TEN), in Southeast Asian countries. Carbamazepine-induced SJS-TEN is strongly associated with the HLA-B*1502 allele. We sought to prevent carbamazepine-induced SJS-TEN by using HLA-B*1502 screening to prospectively identify subjects at genetic risk for the condition.
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Prospective screening for HLA-B*15:02 significantly decreased the incidence of carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) (p<0.001)
|HLA-B*15:02-positive patients who did not take carbamazepine (n=367)||HLA-B*15:02-negative patients who received carbamazepine (n=4120)||Historical incidence|
|Number with SJS/TEN||0||0||10|
Mild, transient rash and itching developed in 211 subjects - 5 were HLA-B*15:02 positive. More severe cutaneous symptoms developed in 7 subjects - 1 was HLA-B*15:02 positive (urticaria).