The aim of this study was to investigate risk factors for cutaneous adverse reactions (CARs) in Kinh Vietnamese.
METHODS: All patients were prospectively recruited in Ho Chi Minh City. Presence of the
HLA-B*58:01 allele was determined by real-time PCR-sequence-specific amplification by using the PG5801 Detection Kit (Pharmigene, Taipei). Patients with severe (
SCARs) and mild (MCARs) CARs and controls were compared for differences in features prospectively collected, and odds ratios (
ORs) with 95% confidence intervals (CIs) were estimated.
RESULTS: On comparing 32 patients with
SCARs and 395 tolerant controls, we identified eight strong risk factors: increased age (OR 15.1 [95% CI 5.8-40.1], P < 0.0001), female sex (OR 333 [40-43,453], P < 0.0001),
allopurinol for asymptomatic
hyperuricemia (OR 955 [120-125,847], P < 0.0001),
allopurinol starting dose > 150 mg (OR 316 [101-122], P < 0.0001),
diuretics intake (OR 304 [35-40,018], P < 0.0001), eGFR < 60 ml/min/1.73 m2 (OR 100 [32-353], P < 0.0001), history of
allopurinol-induced skin reaction (OR 78 [6-10,808], P = 0.004), and
HLA-B*58:01 carriage (OR 147 [45-746], P < 0.0001).
HLA-B*58:01 allele frequency in controls was 7.3%. For MCARs (n = 74), risk factors were eGFR < 60 ml/min/1.73 m2 (OR 4.9 [1.61-14.6], P = 0.006), history of
allopurinol-induced skin reaction (OR 27 [2-3777], P = 0.01), and asymptomatic
hyperuricemia (OR 27 [2-3777], P = 0.01).
CONCLUSION: This study confirmed 8 risk factors, including
HLA-B*58:01, for
SCARs and identified 3 risk factors for MCARs in Kinh Vietnamese.
HLA-B*58:01 genotyping could guide the indication for
allopurinol in Kinh Vietnamese patients with
gout.