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Clinical Usefulness of HLA-B∗58:01 Genotyping in Gouty Arthritis
- Source :
- Journal of Clinical Rheumatology and Immunology, Vol 19, Iss 1, Pp 27-33 (2019)
- Publication Year :
- 2019
- Publisher :
- World Scientific Publishing, 2019.
-
Abstract
- Allopurinol is an effective urate lowering agent but may lead to rare but life-threatening severe cutaneous adverse reactions (SCAR). Genetic predisposition, age, sex, renal function, dosage and concomitant diuretic use are known risk factors of allopurinol related SCAR. Among these factors, HLA-B[Formula: see text]58:01 confers the highest risk. Frequency of the HLA-B[Formula: see text]58:01 allele varies significantly across different ethnic groups. Although the usefulness of HLA-5801 genotyping before initiation of allopurinol has been confirmed by clinical studies, its positive predictive value for SCAR is low because of the low prevalence of HLA-5801 in some localities. Thus, health economic analysis does not consistently show cost-effectiveness of universal screening of HLA-5801 before initiation of allopurinol. However, screening of this genotype in high-risk subjects, including those with renal impairment or advanced age, should be considered on individual basis.
- Subjects :
- hla-b∗58:01
lcsh:Immunologic diseases. Allergy
Cost effectiveness
Allopurinol
Renal function
severe cutaneous adverse reactions
allopurinol
03 medical and health sciences
0302 clinical medicine
Genetic predisposition
medicine
030212 general & internal medicine
Gouty arthritis
Genotyping
cost-effectiveness
030203 arthritis & rheumatology
business.industry
Process Chemistry and Technology
genetic screening
HLA-B
Fuel Technology
Immunology
Economic Geology
hypersensitivity
business
lcsh:RC581-607
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 26613425 and 26613417
- Volume :
- 19
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Rheumatology and Immunology
- Accession number :
- edsair.doi.dedup.....ac571b9b0eb5b8ae307278404b3df28d