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首页> 外文期刊>Clinical and Translational Allergy >Cutaneous adverse drug reactions induced by Oxcarbazepine
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Cutaneous adverse drug reactions induced by Oxcarbazepine

机译：奥卡西平引起的皮肤不良药物反应

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Poster backgroundOxcarbazepine (OXC) is a structural analog of carbamazepine(CBZ). OXC is considered a promising alternativemedication for patients who cannot tolerate CBZ becauseof its equivalent clinical effiecacy and fewer cutaneousadverse drug reactions (cADRs) compared to CBZ. HLAB*15:02 allele was shown to strongly associate with carbamazepine(CBZ)-induced Stevens-Johnson syndrome(SJS)/toxic epidermal necrolysis (TEN) in Chinese andSoutheast Asian populations.However,the epidemiologicaldata about OXC-induced cADRs in recent years is limited.This study aims to investigate the clinical characteristics ofOXC-induced cADRs and their genetic associations withHLA-B*15:02.MethodWe conducted a perspective study of patients with OXCinducedcADRs from Chang Gung Memorial HospitalHealth System and Taiwan-SCAR consortium since 2006to 2013. The diagnosis of OXC-cADRs were based onclinical features, exclusions of alternative causes, supportedby ancillary investigations such as histological andlaboratory findings. Clinical course, latent period, drugdosage, organ involvement, complications and the mortalitywere analyzed. We also examined the HLA-A and -Bgenotypes of all patients with OXC-induced cADRs comparingto OXC-tolerant controls.ResultsThe study included 31 patients with OXC-cADRs, including12 SJS (no TEN case), 4 drug rashes with eosinophiliaand systemic symptoms (DRESS ), 13 maculopapularexanthema (MPE), 2 bullous fixed drug eruption (BFDE)and 101 OXC-tolerant controls. Comparing to CBZ, theclinical severity of OXC-induced SJS and DRESS were lesssevere. All cases of OXC-SJS presented with limited skindetachment (<5%) without mortality, although there weretypical mucosal involvements and typical histopathologiclfindings of epidermal necrosis. All four cases of OXCDRESSalso presented with less severe liver injuries. Interestingly,similar to CBZ-SJS, the HLA study showed HLAB15:02 allele was significantly associated with patientswith OXC-SJS (P< 0.01), but was not associated with otherphenotypes. However, HLA-A*3101 was not significantlyassociated with all phenotypes of OXC-cADRs.ConclusionOur findings suggest that HLA-B*15:02 allele is significantlyassociated with OXC- SJS in Han Chinese.However, the genetic association is phenotype-specific(only for OXC-SJS) and the strength is less than CBZ-SJS/TEN. Furthermore, in comparison to CBZ, OXZ-SJSpresented with less clinical severity and better clinicaloutcomes, suggesting a decrease of antigenicity for inductionof SJS than CBZ.
机译：海报背景奥卡西平（OXC）是卡马西平（CBZ）的结构类似物。对于不能耐受CBZ的患者，OXC被认为是一种有前途的替代药物，因为与CBZ相比，OXC具有等效的临床疗效和较少的皮肤不良药物反应（cADR）。在中国和东南亚人群中，HLAB * 15：02等位基因被证明与卡马西平（CBZ）引起的史蒂文斯约翰逊综合征（SJS）/毒性表皮坏死溶解（TEN）密切相关。本研究旨在探讨OXC诱导的cADR的临床特征及其与HLA-B * 15：02的遗传相关性。方法自2006年至2013年，我们对来自长庚纪念医院卫生系统和台湾SCAR联盟的OXC诱导的cADR患者进行了透视研究。 OXC-cADR的诊断基于临床特征，排除了其他原因，并辅以组织学和实验室检查等辅助检查。分析了临床过程，潜伏期，药物剂量，器官受累，并发症和死亡率。我们还检查了所有OXC诱导的cADR患者的HLA-A和-B基因型与耐OXC的对照相比。结果研究包括31例OXC-cADR患者，包括12例SJS（无TEN病例），4例具有嗜酸性粒细胞增多和全身症状的皮疹（ DRESS），13个斑丘疹性皮疹（MPE），2个大疱性固定药疹（BFDE）和101个OXC耐受对照。与CBZ相比，OXC诱导的SJS和DRESS的临床严重程度较轻。尽管存在典型的粘膜受累和典型的表皮坏死组织病理学发现，但所有OXC-SJS病例均表现出有限的皮肤脱离（<5％）且无死亡。所有四例OXCDRESS的肝脏损伤也较轻。有趣的是，类似于CBZ-SJS，HLA研究显示HLAB15：02等位基因与OXC-SJS患者显着相关（P <0.01），但与其他表型无关。然而，HLA-A * 3101与OXC-cADR的所有表型均不显着相关。结论我们的研究结果表明，HLA-B * 15：02等位基因与汉族人OXC-SJS显着相关，但遗传相关是表型特异性的（仅适用于OXC-SJS），强度小于CBZ-SJS / TEN。此外，与CBZ相比，OXZ-SJS具有较低的临床严重性和更好的临床结果，表明与CBZ相比，诱导SJS的抗原性降低。

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