HLA-A*11:01 is associated with levetiracetam-induced psychiatric adverse events

PLoS One. 2018 Jul 18;13(7):e0200812. doi: 10.1371/journal.pone.0200812. eCollection 2018.

Abstract

Levetiracetam (LEV) is effective for focal and generalized epilepsy and is used worldwide because of its relatively few drug interactions and favorable tolerability. However, some psychiatric adverse events (PAEs) have been reported, resulting in drug withdrawal. The pathophysiology of LEV-induced PAE has not yet been elucidated. In this study, we investigated the relationship between PAEs and human leukocyte antigen (HLA) genes. Eleven epilepsy patients, who developed PAEs after the administration of LEV and spontaneously improved after drug withdrawal, were enrolled retrospectively. Genomic DNA from the peripheral blood was extracted, and four-digit allele genotyping of HLA genes was performed. The genotype frequencies of HLA genes were compared to those of 80 patients in which LEV was well tolerated, as well as to 485 individuals from the general Korean population. The frequency of the HLA-A*1101 allele was significantly higher in the LEV-induced PAEs group compared to both the LEV-tolerant group (p = 0.021, OR 4.80, 95% CI 1.30-17.74) and the general Korean population (p = 0.015, OR 4.62, 95% CI 1.38-15.45). This study is the first attempt at investigating the relationship between the HLA system and LEV-induced PAE. The results of this study suggest that the HLA-A*1101 allele could be a risk factor for the development of PAEs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alleles
  • Epilepsy / drug therapy
  • Epilepsy / genetics
  • Female
  • Genotype
  • HLA-A Antigens / genetics*
  • Humans
  • Levetiracetam / adverse effects*
  • Male
  • Middle Aged
  • Republic of Korea
  • Retrospective Studies

Substances

  • HLA-A Antigens
  • Levetiracetam

Grants and funding

This work was supported by the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2016R1C1B2016275). S.K.L. was supported by Dong-A ST (0620154110). J.M. was supported by Seoul National University Hospital (0420170820). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.