药物遗传学来预防对抗药物的过敏反应:在指示时是否进行测试?
Vy L Bui1, Santiago Alvarez-Arango2,3,4, James M Stevenson2,4
1Department of Pharmacy, The Johns Hopkins Hospital.
Pharmacogenetics and genomics
|October 13, 2023
概括
预先对HLA-B*15:02基因变异进行查对于预防卡巴马西平的严重皮肤不良反应至关重要. 在美国的亚洲患者中,遵守这种药物遗传测试建议仍然很低.
科学领域:
- 药物基因组学 药物基因组学
- 临床药理学 临床药理学
- 药品安全 药品安全
背景情况:
- 建议进行HLA-B*15:02预查,以预防史蒂文斯-约翰逊综合征等严重皮肤不良反应 (SCAR).
- 指导方针提倡在卡巴马泽平或氧卡马泽平之前进行药物遗传学测试,特别是在亚洲人群中.
- 遵守这些建议可能需要改进.
研究的目的:
- 为了评估HLA-B*15:02的预先查率.
- 评估药物遗传学结果的文档化实践.
- 为了确定在亚洲患者中SCARs发病率,开始接受卡巴马西平或氧卡巴马西平.
主要方法:
- 记录有亚洲遗产的患者的回顾性研究.
- 纳入标准:在2016年7月至2021年8月期间开始使用碳胺或氧胺.
- 数据收集的重点是预先查,EHR文档和SCAR发生情况.
主要成果:
- 只有4%的符合条件的患者接受了HLA-B*15:02预先查.
- 在少数接受查的患者中没有报告SCAR.
- 药物遗传结果在EHR中被不一致地记录下来,通常作为各种附件.
结论:
- 存在显著的机会,以提高HLA-B*15:02 预先选合规性.
- 需要改进药物遗传测试和文档,以防止与卡巴马西相关的SCARs.
- 将药物遗传数据系统地整合到电子健康记录中对于患者安全至关重要.
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