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Impact of the HLA-B*58:01 Allele and Renal Impairment on Allopurinol-Induced Cutaneous Adverse Reactions Chau Yee Ng, Yu-Ting Yeh, Chuang-Wei Wang, Shuen-Iu Hung, Chih-Hsun Yang, Ya-Ching Chang, Wan-Chun Chang, Yu-Jr Lin, Chee-Jen Chang, Shih-Chi Su, Wen-Lang Fan, Der-Yuan Chen, Yeong-Jian Jan Wu, Ya-Chung Tian, Rosaline Chung-Yee Hui, Wen- Hung Chung Journal of Investigative Dermatology Volume 136, Issue 7, Pages (July 2016) DOI: /j.jid Copyright © 2016 The Authors Terms and Conditions
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Figure 1 The associations of the HLA-B∗58:01 allele with different allopurinol-related cADRs phenotypes in Taiwan population. In the column for odds ratios, values indicate odds ratios and horizontal lines indicate 95% confidence intervals. BSA, body surface area; cADR, cutaneous adverse reaction; CI, confidence interval; DRESS, drug reaction with eosinophilia and systemic symptoms; MPE, maculopapular exanthema; SCAR, severe cutaneous adverse reaction; SJS, Stevens-Johnson syndrome; TEN, toxic epidermal necrosis. Journal of Investigative Dermatology , DOI: ( /j.jid ) Copyright © 2016 The Authors Terms and Conditions
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Figure 2 Meta-analysis of associations of HLA-B∗58:01 allele with allopurinol-induced cADRs in different populations. Meta-analysis of associations of HLA-B∗58:01 with allopurinol-induced cADRs, including SJS/TEN, DRESS, and MPE, in matched- and population-controls in this study and 10 other studies. The associations studies of HLA-B∗58:01 in matched- (allopurinol cADRs) and general population-controls was shown. CI, confidence interval; DRESS, drug reaction with eosinophilia and systemic symptoms; HLA, human leukocyte antigen; M-H, Mantel-Haenszel test; MPE, maculopapular exanthema; SJS, Stevens-Johnson syndrome; TEN, toxic epidermal necrosis. Journal of Investigative Dermatology , DOI: ( /j.jid ) Copyright © 2016 The Authors Terms and Conditions
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Figure 3 Analysis of the impact of the HLA-B*58:01 allele and renal impairment on allopurinol-induced cADRs. (a) ORs for allopurinol-induced cADRs in relation to renal function (eGFR >60, 30–60, and <30 mL/minute/1.73 m2) and presence of the HLA-B*58:01 risk allele (heterozygous and homozygous). Compared with allopurinol-tolerant subjects, the ORs were 3.82, 15.25, 72.45, , and 1, for the risk factors eGFR < 30 mL/minute/1.73 m2 alone, heterozygous HLA-B*58:01 with normal renal function, homozygous HLA-B*58:01 with normal renal function, heterozygous HLA-B*58:01 with an eGFR < 30 mL/minute/1.73 m2, and homozygous HLA-B*58:01 with an eGFR < 30 mL/minute/1.73 m2, respectively (P < for all). (b) ROC curve for poor renal function and HLA-B*58:01 risk allele. The AUC was highest for concomitant presence of the homozygous HLA-B*58:01 allele and an eGFR < 30 mL/minute/1.73 m2. AUC, area under the curve; cADR, cutaneous adverse reaction; CI, confidence interval; eGFR, estimated glomerular filtration rate; OR, odds ratio; PPV, positive predictive value; ROC, receiver operating characteristic. Journal of Investigative Dermatology , DOI: ( /j.jid ) Copyright © 2016 The Authors Terms and Conditions
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