Table 2.
Clinical implementation of pharmacogenomic testing for prevention of SCAR.
Drug | Biomarker | Clinical application | Pharmacogenomic information in drug labeling and guideline |
---|---|---|---|
Abacavir | HLA-B*57:01 | Application of HLA-B*57:01 testing in clinical practice in Australia, Europe, the US, Thailand, etc. | The US FDA, US HHS, EMA, Canada HCSC, and multiple international HIV/AIDS organizations suggest HLA-B*57:01 genetic testing is required before the first use of abacavir. |
Allopurinol | HLA-B*58:01 | Application of HLA-B*58:01 testing in clinical practice in Asian countries including Taiwan, Thailand, Korea, and China. | 1. The American College of Rheumatology guidelines for the management of gout recommended HLA-B*58:01 testing prior to allopurinol administration. 2. Reimbursement of the testing is supported by national health insurance in China, Taiwan, and Korea. An ongoing project of free test is provided in medical centers in Thailand. |
Carbamazepine | HLA-B*15:02 | 1. Application of HLA-B*15:02 testing in clinical practice in Taiwan, Hong Kong, Singapore, Thailand, etc. | 1.The US FDA and Taiwan FDA label HLA-B*15:02
genetic testing is required before the first use of CBZ. 2. Canada HCSC and other drug regulatory agencies such as Thailand HITAP, Hong Kong Department of Health, Singapore Ministry of Health, India MOHFW, and EMA recommend performing HLA-B*15:02 genetic testing before the use of CBZ for patients with certain Asian background. 3. Reimbursement of the testing is supported by national health insurance in Taiwan, China, Hong Kong, Singapore, and Thailand |
Carbamazepine | HLA-A*31:01 | Ongoing clinical trial of prospective screening of HLA-A*31:01 before prescribing CBZ in Japan | 1. US FDA labels the risk of this allele related to CBZ hypersensitivity. 2.Canada HCSC recommends HLA-A*31:01 genetic testing before the use of CBZ in genetically at-risk populations. |
Dapsone | HLA-A*31:01 | Prospective screening of HLA-B*13:01 before prescribing dapsone in China. | |
Oxcarbazepine | HLA-B*15:02 | HLA-B*15:02 was found to be significantly associated with OXC-SJS/TEN in Han Chinese and Thai patients. | The US FDA and Taiwan FDA recommend HLA-B*15:02 genetic testing before the use of OXC in patients of Asian ancestry with a high genetic background. |
Phenytoin | HLA-B*15:02 and CYP2C9 | Ongoing clinical trial prospective screening of CYP2C9*3 with HLA alleles before prescribing PHT in Taiwan | Canada HCSC recommends HLA-B*15:02 genetic testing before the use of PHT. |