HLA genotypes and cold medicine-induced Stevens–Johnson syndrome/toxic epidermal necrolysis with severe ocular complications: a systematic review and meta-analysis

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<jats:title>Abstract</jats:title><jats:p>Serious cutaneous adverse drug reactions [i.e., SJS/TEN with severe ocular complications (SOC)] associated with cold medicine (CM) were reported in several studies. To assess the risks of CM-induced SJS/TEN with SOC, systematic review and meta-analysis were employed. Studies investigating associations between <jats:italic>HLA</jats:italic> genotypes and CM-induced SJS/TEN with SOC were systematically searched in PubMed, Scopus and the Cochrane Library. Overall odds ratios (ORs) with 95% CIs were calculated using a random-effects model to determine these associations. An initial search of the databases identified 24,011 articles, of which 6 studies met the inclusion criteria. In total from all studies, associations between 81 different HLA genotypes and CM-induced SJS/TEN with SOC (i.e., 22 different <jats:italic>HLA-A</jats:italic> genotypes, 40 different <jats:italic>HLA-B</jats:italic> genotypes and 19 different <jats:italic>HLA-C</jats:italic> genotypes) were investigated. Risk factors to develop SJS/TEN with SOC in patients who used CM were identified from our meta-analysis. <jats:italic>HLA-A*0206</jats:italic> (OR = 3.90; 95% CI = 1.96–7.77)<jats:italic>, HLA-A*3303</jats:italic> (OR = 2.28; 95% CI = 1.31–3.97)<jats:italic>, HLA-B*4403</jats:italic> (OR = 3.27; 95% CI = 1.52–7.03) and <jats:italic>HLA-C*0501</jats:italic> (OR = 2.55; 95% CI = 1.19–5.44) were associated with CM-induced SJS/TEN with SOC. With our results demonstrating a significant association between using of CMs and the severe ADR, a genetic testing can be helpful. However, the CMs are commonly used as an over-the-counter drug in practically almost of people in populations worldwide, the genetic screening prior to use of the CMs might not be cost-effective. Nonetheless, for people with a family history of developing the ADRs with a possible involvement of CMs, a genetic screening may be beneficial.</jats:p>

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  • Scientific Reports

    Scientific Reports 10 (1), 2020-06-29

    Springer Science and Business Media LLC

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