A retrospective investigation of HLA-B*5801 in hyperuricemia patients in a Han population of China

Pharmacogenet Genomics. 2018 May;28(5):117-124. doi: 10.1097/FPC.0000000000000334.

Abstract

Background: Hyperuricemia and gout have become increasingly prevalent in China. Allopurinol is an effective urate-lowering therapy, but it has severe side effects. HLA-B*5801 is highly associated with the allopurinol-induced toxic epidermal necrolysis and Stevens-Johnson syndrome.

Patients and methods: In this retrospective report, we had genotyped HLA-B*5801 in 253 cases of hyperuricemia and gout patients in a Han population in Shenzhen and analyzed the clinical management of medications.

Results: We found 30 carriers of the HLA-B*5801 allele in 253 cases of hyperuricemia or gout patients in the population (11.9%). Allopurinol was prescribed in both HLA-B*5801-positive and HLA-B*5801-negative groups. The evaluation of four models with or without genetic screening and management of allopurinol or febuxostat indicated that the HLA-B*5801 screening had significant cost benefit for clinical management.

Conclusion: For appropriate management and cost-effectiveness, the HLA-B*5801 allele should be screened in all patients with hyperuricemia and gout in the Chinese population.

MeSH terms

  • Adult
  • Allopurinol / economics
  • Allopurinol / therapeutic use*
  • China / ethnology
  • Cost-Benefit Analysis
  • Febuxostat / economics
  • Febuxostat / therapeutic use*
  • Female
  • Gene Frequency
  • Genetic Testing / economics
  • Gout / drug therapy
  • Gout / ethnology
  • Gout / genetics*
  • Gout Suppressants / economics
  • Gout Suppressants / therapeutic use*
  • HLA-B Antigens / genetics*
  • Humans
  • Hyperuricemia / drug therapy
  • Hyperuricemia / ethnology
  • Hyperuricemia / genetics*
  • Male
  • Middle Aged
  • Precision Medicine
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Gout Suppressants
  • HLA-B Antigens
  • HLA-B*58:01 antigen
  • Febuxostat
  • Allopurinol