Progress on relation between human leukocyte antigen gene and oxcarbazepine induced cutaneous adverse drug reactions

Oxcarbazepine (OXC) is a new antiepileptic drug developed through structural variation of carbamazepine and widely used for the patient who cannot tolerate carbamazepine. Although OXC has a lower risk of cutaneous adverse drug reactions (cADRs) than carbamazepine, it has been reported that OXC-induced cutaneous adverse drug reactions (OXC-cADRs) are prevalent and may lead to drug discontinua-tion. HLA-B*15: 02 is associated with oxcarbazepine-induced SJS/TEN, but not maculopapule, which is similar to carbamazepine. In addition, HLA-A*13: 02, HLA-B*38: 02 and HLA-B*40: 02 are HLAⅠtype genes which is related to oxcarbazepine-induced maculopapule (OXC-MPE), and HLA-DRB1*04: 03 was first HLA class II gene found associated with OXC-MPE. The risk factor of OXC-cADRs is still not completely clear. Age, gender, weight and total dose of medication were not correlated with OXC-MPE. Allergy induced by antiepileptic drugs and non-antiepileptic drug induced allergy may be risk factors of OXC-cADRs. Attention should be paid to cross-allergic reactions before using oxcarbazepine for patients with a history of carbamazepine-induced allergy. Genetic test is not currently recommended in patients with maculopapule. Aromatic antiepileptic drugs should be avoided in patients with positive expression of HLA-B*15: 02 gene. Key words: Drug toxicity; Stevens-Johnson syndrome; Epidermal necrolysis, toxic; Human leukocyte antigens