Friday, June 21, 2013

CPIC publishes guidelines for HLA-B*15:02 Genotype and Carbamazepine Use

The Clinical Pharmacogenomics Implementation Consortium (CPIC) has published guidelines for the use of genetic test results for HLA-B*15:02 and carbamazepine in Clinical Pharmacology and Therapeutics.  In cases where a patient is known to carry at least one HLA-B*15:02 allele, the guideline recommends that the clinician use another drug due to the increased risk of carbamazepine-induced Stevens-Johnson Syndrome (SJS)/toxic epidermis necrolysis (TEN) associated with that allele.

Carbamazepine is an aromatic anti-convulsant used in the treatment of epilepsy and other seizure disorders.  However, there is a risk of dangerous, even fatal, skin reactions such as SJS and TEN for patients taking the drug.  An association with the HLA-B*15:02 allele and increased risk for these carbamazepine-induced reactions has been established.  The FDA recommends testing for this allele in certain populations where the allele is most common.  The CPIC guidelines recommend an alternative treatment for anyone carrying the HLA-B*15:02 allele regardless of ethnicity.

See the excerpts and recommendations from the guidelines and download the CPT article and supplement here.