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Meta-Analysis
. 2020 Jun 29;10(1):10589.
doi: 10.1038/s41598-020-67610-5.

HLA genotypes and cold medicine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis with severe ocular complications: a systematic review and meta-analysis

Wimonchat Tangamornsuksan  1 , Sirikan Chanprasert  2   3 , Phenphechaya Nadee  3   4 , Saowalak Rungruang  3   4 , Natnaree Meesilsat  3 , Mayumi Ueta  5 , Manupat Lohitnavy  6   7   8
Affiliations
Meta-Analysis

HLA genotypes and cold medicine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis with severe ocular complications: a systematic review and meta-analysis

Wimonchat Tangamornsuksan et al. Sci Rep. .

Abstract

Serious cutaneous adverse drug reactions [i.e., SJS/TEN with severe ocular complications (SOC)] associated with cold medicine (CM) were reported in several studies. To assess the risks of CM-induced SJS/TEN with SOC, systematic review and meta-analysis were employed. Studies investigating associations between HLA genotypes and CM-induced SJS/TEN with SOC were systematically searched in PubMed, Scopus and the Cochrane Library. Overall odds ratios (ORs) with 95% CIs were calculated using a random-effects model to determine these associations. An initial search of the databases identified 24,011 articles, of which 6 studies met the inclusion criteria. In total from all studies, associations between 81 different HLA genotypes and CM-induced SJS/TEN with SOC (i.e., 22 different HLA-A genotypes, 40 different HLA-B genotypes and 19 different HLA-C genotypes) were investigated. Risk factors to develop SJS/TEN with SOC in patients who used CM were identified from our meta-analysis. HLA-A*0206 (OR = 3.90; 95% CI = 1.96-7.77), HLA-A*3303 (OR = 2.28; 95% CI = 1.31-3.97), HLA-B*4403 (OR = 3.27; 95% CI = 1.52-7.03) and HLA-C*0501 (OR = 2.55; 95% CI = 1.19-5.44) were associated with CM-induced SJS/TEN with SOC. With our results demonstrating a significant association between using of CMs and the severe ADR, a genetic testing can be helpful. However, the CMs are commonly used as an over-the-counter drug in practically almost of people in populations worldwide, the genetic screening prior to use of the CMs might not be cost-effective. Nonetheless, for people with a family history of developing the ADRs with a possible involvement of CMs, a genetic screening may be beneficial.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram of HLA genotypes and CM-induced SJS/TEN with SOC.
Figure 2
Figure 2
Forest plots of statistically significant associations between HLA-A genotypes and CM-induced SJS/TEN with SOC (A), statistically significant associations between HLA-B genotypes and CM-induced SJS/TEN with SOC (B), statistically significant associations between HLA-C genotypes and CM-induced SJS/TEN with SOC genotypes and CM-induced SJS/TEN with SOC.
See this image and copyright information in PMC

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