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HLA-associated adverse drug reactions - scoping review
Chiara Jeiziner1, Ursina Wernli1, Katja Suter2
1Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Clinical and Translational Science
|June 9, 2021
Summary
Pre-emptive human leukocyte antigen (HLA) testing may prevent adverse drug reactions (ADRs). This review found significant complexity and uncertainty in current evidence linking specific HLA alleles to drug responses.
Area of Science:
- Pharmacogenomics
- Immunogenetics
- Drug Safety
Background:
- Human leukocyte antigen (HLA) alleles are linked to idiosyncratic adverse drug reactions (ADRs).
- Pre-emptive HLA typing is hypothesized to prevent ADRs in susceptible individuals.
- Understanding the evidence for HLA-associated ADRs is crucial for personalized medicine.
Purpose of the Study:
- To conduct a scoping review of evidence associating HLA alleles with ADRs for drugs available in Switzerland.
- To synthesize current research on HLA-associated ADRs.
- To identify gaps and challenges in the field.
Main Methods:
- Scoping review following PRISMA guidelines.
- Literature search of PubMed and Embase (July 2020).
- Inclusion of studies from 2002 onwards, investigating HLA-associated ADRs with Swiss-marketed small molecules.
Main Results:
- 149 studies were included, predominantly retrospective.
- The most frequent association reported was HLA-B*15:02 with carbamazepine (33 studies).
- High heterogeneity in ADR definitions, HLA alleles, participant numbers, and study designs precluded direct comparison.
Conclusions:
- The current evidence for HLA-associated ADRs is complex and uncertain.
- Consistent phenotype definitions and harmonized reporting structures are needed for future association studies.
- Further research is required to clarify the role of HLA typing in ADR prevention.
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