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Carbamazepine DRESS Syndrome — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersCarbamazepine DRESS SyndromeSCE Neurology

A 24-year-old man of Han Chinese ancestry is about to start carbamazepine for focal epilepsy. He has never taken an aromatic antiseizure medicine. Which pre-treatment pharmacogenetic approach is most appropriate?

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Correct answer: D — Whenever possible test HLA-B*1502 because it strongly predicts severe carbamazepine-associated SJS/TEN

HLA-B*1502 is strongly associated with severe carbamazepine-related SJS/TEN in Han Chinese and Thai populations, so screening should be performed whenever possible before exposure. HLA-A*3101 is associated with a broader range of cutaneous reactions in European and Japanese populations, but a negative result does not abolish risk and the SmPC does not support universal screening on that basis. HLA-B*5701 is associated with abacavir, and CYP2C19 is not the relevant test.

Reference: Carbamazepine Summary of Product Characteristics: https://www.medicines.org.uk/emc/product/3060/smpc