Allopurinol pharmacogenetics: assessment of potential clinical usefulness

Pharmacogenomics. 2011 Dec;12(12):1741-9. doi: 10.2217/pgs.11.131.

Abstract

Use of pharmacogenetics to inform treatment decisions remains a priority for clinicians, patients and public health agencies. We previously developed a framework for systematically assessing whether pharmacogenetic test information would likely bring value to clinical decision-making and enjoy practical uptake. We applied this tool to allopurinol to determine potential usefulness of HLA genetic information in assessing risk for allopurinol-induced severe cutaneous adverse reactions. We quantified allopurinol use data and the magnitude of adverse event signals using US FDA databases, reviewed reported cases of allopurinol-associated severe cutaneous adverse reactions to assess whether clinical subtypes of patients could be identified, performed pooled analyses of associations between HLA variation and allopurinol-induced severe cutaneous adverse reactions and described considerations in clinical implementation of allopurinol pharmacogenetics.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Allopurinol / adverse effects*
  • Allopurinol / therapeutic use
  • Child
  • Erythema Multiforme / chemically induced
  • Erythema Multiforme / genetics
  • Female
  • Genetic Association Studies
  • Genetic Testing / methods*
  • Genetic Variation*
  • Gout / drug therapy
  • Gout Suppressants / adverse effects*
  • Gout Suppressants / therapeutic use
  • HLA Antigens / genetics*
  • Humans
  • Hyperuricemia / drug therapy
  • Male
  • Middle Aged
  • Pharmacogenetics
  • Risk Assessment
  • Skin Diseases / chemically induced
  • Skin Diseases / genetics*
  • Stevens-Johnson Syndrome / chemically induced
  • Stevens-Johnson Syndrome / etiology
  • Stevens-Johnson Syndrome / genetics

Substances

  • Gout Suppressants
  • HLA Antigens
  • Allopurinol