Incidence and Genotypic Association of AED Related CADRs in a Sample Population of Hispanics and African American Patients of North America (P05.088)

Abstract

Objective: Study the incidence and genotypic association of Anti-epileptic Drug(AED) related Cutaneous Adverse Drug Reactions(CADRs) in a sample population of Hispanics and African American patients of North America. Background Strong association between HLA-B1502 and carbamazepine induced Stevens Johnson Syndrome (SJS) mandated genotypic screening in people of Chinese/Asian ethnicity.Incidence of AED related CADRs in Hispanic and African American patients and its genotypic associations are not clearly defined.Identification of patterns of CADRs with various AEDs and potential Human Leukocyte Antigen ( HLA) marker will enable appropriate selection of AEDs. Design/Methods: Charts of patients who were initiated on AEDs between January 2008 and December 2010 at the Drexel University College of Medicine Neurology Clinic were reviewed.Cases of AED related CADRs with in 60 days of initiation of the medication were identified. Information regarding their race and ethnicity,drug involved and severity of CADRs was recorded. Buccal swabs of cases with Hispanic and African American lineage were collected and sent to identify association between AED related CADRs and HLA alleles through proxy single-nucleotide polymorphisms and imputation, confirming associations by high-resolution sequence-based HLA typing.Enrollment for obtaining buccal swabs for the study is current. Results: 295consecutive patients were inititated on AED during the study period. 30 cases(11 African American,11 Hispanic,8 Caucasian)of moderate CADRs were identified. A female predominance(5:1)was noted. CADRs were linked to carbamazepine,lamotrigine,valproic acid and Phenobarbital in 10,7,6 and 4 cases respectively. Buccal swabs of 10 cases( 5 African American, 5 Hispanics) and 10 matched controls has been sent for HLA typing, results of which are pending. Conclusions: AED related CADRs are more common in females and most frequent with carbamazepine.Carbamazepine induced CADRs has been linked to HLA-B1502 and HLA-A3101 in asian and caucasians respectively. The results of our HLA studies may identify genotypic association between AED related CADRs in African American and Hispanic populations of North America. Supported by: Dept of Neurology-Drexel University College of Medicine, American Red Cross-Philadelphia. Disclosure: Dr. Ambady has nothing to disclose. Dr. Pillai has nothing to disclose. Dr. Arora has nothing to disclose.