Study on the relationship between adverse drug reactions of carbamazepine and HLA-B*1502 genetic polymorphism and blood concentration

Abstract

Objective： To study the relationship between genetic polymorphism，blood concentration and adverse drug reactions（ADRs） of carbamazepine（CBZ），so as to promote clinical safety and reasonable use of CBZ.Methods： Clinical medical data of the inpatients treated in Ruijin Hospital Affiliated to School of Medicine，Shanghai Jiao Tong University from 2017 to 2019 were collected retrospectively.Data concerning HLA-B*1502 gene detection and serum concentration of CBZ were collected to analyze the relationship between HLA-B*1502 genotype and ADRs of CBZ in the patients.Results： A total of 148 patients were enrolled for study，of whom 101 patients received HLA-B*1502 genotypes detection，with the genotype of 34 patients being positive，accounting for 33.66%.In the 148 patients，78 were treated with CBZ（53.79%），among whom 60 patients（86 case times） received serum drug concentration detection of CBZ.The serum drug concentration in 53 case times was within the recommended concentration range，accounting for 61.63% of the detected case times，and the serum drug concentration in 32 case times（37.21%） was lower than that of the recommended data.CBZ-related ADRs occurred in 12 cases（15.38%），of which one patient with HLA-B*1502 homozygous mutation developed severe skin ADRs after taking CBZ.Conclusion： There is close association between HLA-B*1502 genotype and skin ADRs induced by CBZ.The treatment window of CBZ is narrow，and the rate of ADRs might be associated with blood concentration of CBZ.Gene detection and blood concentration detection are of great significance to the improvement of the safety of CBZ in clinical practice.