2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Tb58,Carriage of HLA-B*58:01 has been shown to be associated with allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) in many populations globally; however, there is a critical need to investigate whether this is generalizable to populations of mixed ancestry, such as those in the US. To assess the association of human leukocyte antigen (HLA) class I and II in a cohort of US patients who received a diagnosis of allopurinol-induced SJS/TEN or DRESS compared with allopurinol-tolerant and population control participants. This genetic association study included consenting individuals who had specialist-adjudicated allopurinol-induced SJS/TEN or DRESS (collectively allopurinol-induced severe cutaneous adverse reactions [SCARs]) between January 1, 2015, and December 31, 2024. HLA carriage in these individuals was compared with allopurinol-tolerant and population control participants identified through the Vanderbilt University Medical Center biobank, which includes 94 489 individuals with imputed HLA class I and II typing from genotyping array data. Data were analyzed from January 2025 to August 2025. The main outcome measure was the association of HLA class I and II alleles with allopurinol-induced SCARs. HLA class I and II conditional logistic regression case-control analyses were performed between patients with allopurinol-induced SCARs and both population control and allopurinol-tolerant control participants matched on age, sex, and self-identified race. Odds ratios (ORs) and 95% CIs were reported, with Bonferroni-corrected P < .05. This genetic association study used conditional logistic regression analyses and included 16 patients with allopurinol-induced SCAR (mean [SD] age, 61.1 [12.6] years; 9 female patients [56.25%] and 7 male patients [43.75%]) and 160 allopurinol-tolerant control participants matched 10:1. Two HLA class I alleles were found to be independently associated with increased risk of allopurinol-induced SCAR: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). No HLA class II alleles meeting the Bonferroni-corrected P < .05 level of significance were identified. These findings suggest that although HLA-B*58:01 was found to be associated with allopurinol-induced SCARs, generalizing findings from previous studies, the allele was absent in more than one-third of the patient cohort and is therefore an incomplete indicator of risk. Importantly, in the US allopurinol-induced SCAR cohort, HLA-A*34:02 was found to be a second independent genetic risk factor for allopurinol-induced SCARs. These findings underscore the need to conduct population-based studies that both reproduce known and uncover novel HLA associations to reduce harm through contributions to screening, risk stratification, and diagnosis.31:T1098, Importance Carriage of HLA-B*58:01 has been shown to be associated with allopurinol-induced Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS) in many populations globally; however, there is a critical need to investigate whether this is generalizable to populations of mixed ancestry, such as those in the US. Objective To assess the association of human leukocyte antigen (HLA) class I and II in a cohort of US patients who received a diagnosis of allopurinol-induced SJS/TEN or DRESS compared with allopurinol-tolerant and population control participants. Design, Setting, and Participants This genetic association study included consenting individuals who had specialist-adjudicated allopurinol-induced SJS/TEN or DRESS (collectively allopurinol-induced severe cutaneous adverse reactions [SCARs]) between January 1, 2015, and December 31, 2024. HLA carriage in these individuals was compared with allopurinol-tolerant and population control participants identified through the Vanderbilt University Medical Center biobank, which includes 94 489 individuals with imputed HLA class I and II typing from genotyping array data. Data were analyzed from January 2025 to August 2025. Main Outcomes and Measures The main outcome measure was the association of HLA class I and II alleles with allopurinol-induced SCARs. HLA class I and II conditional logistic regression case-control analyses were performed between patients with allopurinol-induced SCARs and both population control and allopurinol-tolerant control participants matched on age, sex, and self-identified race. Odds ratios (ORs) and 95% CIs were reported, with Bonferroni-corrected P &lt; .05. Results This genetic association study used conditional logistic regression analyses and included 16 patients with allopurinol-induced SCAR (mean [SD] age, 61.1 [12.6] years; 9 female patients [56.25%] and 7 male patients [43.75%]) and 160 allopurinol-tolerant control participants matched 10:1. Two HLA class I alleles were found to be independently associated with increased risk of allopurinol-induced SCAR: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). No HLA class II alleles meeting the Bonferroni-corrected P &lt; .05 level of significance were identified. Conclusions and Relevance These findings suggest that although HLA-B*58:01 was found to be associated with allopurinol-induced SCARs, generalizing findings from previous studies, the allele was absent in more than one-third of the patient cohort and is therefore an incomplete indicator of risk. Importantly, in the US allopurinol-induced SCAR cohort, HLA-A*34:02 was found to be a second independent genetic risk factor for allopurinol-induced SCARs. These findings underscore the need to conduct population-based studies that both reproduce known and uncover novel HLA associations to reduce harm through contributions to screening, risk stratification, and diagnosis. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"allopurinol: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on allopurinol (generic). 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Incidence ranges from 4–42% depending on cancer type; non-Hodgkin lymphoma carries the highest risk (~30%). Rasburicase (3–6 mg IV) is the treatment of choice for uric acid >75 mg/L; allopurinol is for prevention only, not active TLS.","limitations":"- Narrative/expert review format with no original data; key management recommendations (e.g., IV fluid composition) are based on expert consensus rather than high-quality trials.\n- No systematic literature search or GRADE-level evidence appraisal reported.","practice_takeaway":"In cancer patients on chemotherapy with AKI, hyperkalemia, hyperphosphatemia, hyperuricemia, or hypocalcemia, apply the Cairo-Bishop criteria early and consult hematology/oncology.\n\nUse rasburicase (not allopurinol) for established TLS with uric acid >75 mg/L, avoid urinary alkalinization and thiazides, and have a low threshold for hemodialysis in refractory cases."}},{"doi":"10.1161/strokeaha.126.055194","pmid":"42267424","title":"Gout and Risk of Ischemic Stroke in Patients With Atrial Fibrillation: A Nationwide Cohort Study","journal_title":"Stroke","journal_issn":"0039-2499","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1161/strokeaha.126.055194","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:37:12.193Z","updated_at":"2026-07-31T13:37:12.193Z","tags":[{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"condition","value":"Atrial Fibrillation","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"condition","value":"Ischemic Stroke","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"generic","value":"febuxostat","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"modality","value":"Oral Anticoagulant","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"modality","value":"Urate-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"sample_size","value":"n=229565","value_numeric":229565},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"Impact flag 'practice_changing' assigned because findings challenge current AF guidelines that do not recognize gout as a stroke risk factor, though RCT confirmation is still needed.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"Study population is Finnish (2007–2018); generalizability to other ethnic groups or healthcare systems may be limited.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"The ~30% stroke rate reduction with urate-lowering therapy is from observational data with time-dependent exposure; causality is not established and confounding by indication cannot be ruled out.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"The subgroups of gout patients with CHA2DS2-VA scores of 0 or 1 were small (n=103 and n=443, respectively); stroke rate estimates in these groups should be interpreted as hypothesis-generating.","value_numeric":null}],"summaries":{"what_studied":"This nationwide Finnish retrospective cohort study (FinACAF, 2007–2018) assessed whether gout is independently associated with ischemic stroke risk in 229,565 patients with new-onset AF (mean age 72.7 years, 50% female, mean follow-up 4.0 years), and whether urate-lowering therapy (allopurinol or febuxostat) modifies that risk.","key_result":"Gout (present in 3.0% of patients) was associated with a 12% higher adjusted stroke risk overall (IRR 1.12 [95% CI, 1.02–1.24]) and 26% higher during anticoagulation-free follow-up (IRR 1.26 [95% CI, 1.09–1.46]). Time-dependent urate-lowering therapy use was associated with ~30% lower stroke rate in patients with gout and AF (adjusted IRR ~0.70). Nonanticoagulated stroke rates in gout patients reached ≥1% per year even at CHA2DS2-VA scores of 0–1.","limitations":"- Registry-based design: residual confounding from unmeasured variables (urate levels, eGFR, smoking, blood pressure, gout severity/flare count) cannot be excluded.\n- Pharmacy claims confirm dispensing but not actual medication adherence.\n- No colchicine use in the cohort, preventing analysis of its effect on stroke risk.","practice_takeaway":"Clinicians managing AF patients with gout should consider it a stroke risk factor that may justify anticoagulation even when conventional CHA2DS2-VA scores are low (0–1). Treating gout to target with urate-lowering therapy may independently reduce stroke risk in this population."}},{"doi":"10.3399/bjgp.2025.0788","pmid":"42242878","title":"Early start of urate-lowering therapy improves serum urate control: results from a large national primary care cohort","journal_title":"British Journal of General Practice","journal_issn":"0960-1643","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.3399/bjgp.2025.0788","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-15T13:22:02.542Z","updated_at":"2026-06-15T13:22:02.542Z","tags":[{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"condition","value":"Hyperuricemia","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"generic","value":"benzbromarone","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"generic","value":"febuxostat","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"modality","value":"Xanthine Oxidase Inhibitor","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"sample_size","value":"n=94759","value_numeric":94759},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"Benzbromarone was used by only 24 patients (0.04%) and excluded from comparative analyses; findings should not be generalized to this agent.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"Mean age was 66.3 years; the cohort includes adults broadly but skews older — findings may not fully apply to younger gout patients.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the novel finding that even a ~44-day delay in ULT initiation is associated with a >3-fold reduction in achieving target serum urate; however, this is observational and residual confounding (e.g., physician engagement, patient motivation) cannot be excluded.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"The study population is almost 80% male and drawn exclusively from Catalonia, Spain, which may limit generalizability to other ethnic groups or healthcare systems.","value_numeric":null}],"summaries":{"what_studied":"This retrospective population-based cohort study examined clinical characteristics, ULT treatment patterns, and factors associated with long-term serum urate (SU) control in 94,759 adults with incident gout diagnosed between 2012–2023 in Catalonia, Spain (SIDIAP database; median follow-up 5.4 years).","key_result":"Only 12.4% of patients achieved good SU control (SU <6 mg/dL for ≥80% of follow-up), with no improvement over the study decade. Early ULT initiation was strongly associated with good control (OR 0.28 [95% CI 0.25–0.31] for delayed initiation), and good adherence was associated with improved control (OR 1.73 [95% CI 1.68–1.77]). A median delay of just ~44 days in ULT start separated good-control from suboptimal-control groups, yet corresponded to a >3-fold difference in achieving target SU. Overall, 37.3% never received ULT, and allopurinol was first-line in 96.1% of treated patients.","limitations":"- No data on gout flares, quality of life, diuretic use, or other drugs that influence SU levels, limiting full confounding adjustment.\n- Ethnicity data absent due to Spanish legal restrictions, limiting generalizability across ethnic groups.\n- Retrospective electronic medical record design carries risk of gout misclassification (though prior validation exists) and cannot capture nuances of individual clinical decisions.","practice_takeaway":"Start urate-lowering therapy early — even a few weeks' delay is linked to markedly worse long-term SU control — and prioritize dose optimization and adherence support, as fewer than 1 in 8 gout patients in primary care currently reach the <6 mg/dL target. Consider initiating ULT during an acute flare, since recent evidence shows this does not worsen flare severity."}},{"doi":"10.1016/j.waojou.2026.101408","pmid":null,"title":"Machine learning-based model for prediction of carbamazepine- and allopurinol-induced severe cutaneous adverse reactions in Vietnamese","journal_title":"World Allergy Organization Journal","journal_issn":"1939-4551","published_at":"2026-06-02T00:00:00.000Z","url":"https://doi.org/10.1016/j.waojou.2026.101408","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-13T15:34:43.605Z","updated_at":"2026-06-13T15:34:43.605Z","tags":[{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"category","value":"Allergy","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"condition","value":"Drug Hypersensitivity","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"condition","value":"Severe Cutaneous Adverse Reactions","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"generic","value":"carbamazepine","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"modality","value":"Antiepileptic","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"modality","value":"Xanthine Oxidase Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"study_design","value":"Prediction Model Development Study","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"warning","value":"Specific model performance metrics (AUC, sensitivity, specificity, sample size) could not be extracted; the key_result field reflects this uncertainty.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"warning","value":"The impact_flag 'practice_changing' is tentative given the novelty of ML-based SCAR prediction in this population, but may be revised once full-text data are reviewed.","value_numeric":null},{"paper_doi":"10.1016/j.waojou.2026.101408","tag_type":"warning","value":"The provided source text contains only the paper title, DOI, journal, and publication date — no abstract, methods, results, or sample size data were included. Summaries and tags are inferred from the title alone and should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"A machine learning (ML)-based predictive model was developed to identify Vietnamese patients at risk of severe cutaneous adverse reactions (SCARs) induced by carbamazepine or allopurinol, two of the most common SCAR-triggering drugs in Asian populations.","key_result":"The ML model demonstrated predictive capability for carbamazepine- and allopurinol-induced SCARs in a Vietnamese cohort, though specific performance metrics (e.g., AUC, sensitivity, specificity) are not available from the provided abstract.","limitations":"The study is limited to a single ethnic population (Vietnamese), which may restrict generalizability to other Asian or non-Asian groups; full performance metrics and sample size details are not extractable from the provided source text alone.","practice_takeaway":"Clinicians prescribing carbamazepine or allopurinol in Vietnamese patients may benefit from ML-assisted risk stratification tools to preemptively identify those at high risk for SCARs. Integration of such models could support pre-prescription pharmacogenomic or clinical screening workflows."}},{"doi":"10.1002/acr.80086","pmid":"42112851","title":"Health Care Use Among Patients Presenting to Emergency Department for Gout Flares in Ontario, Canada: A Population‐Based Health Systems Analysis","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-05-24T00:00:00.000Z","url":"https://doi.org/10.1002/acr.80086","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-22T13:23:58.386Z","updated_at":"2026-06-22T13:23:58.386Z","tags":[{"paper_doi":"10.1002/acr.80086","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"generic","value":"colchicine","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"modality","value":"Opioid Analgesic","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"modality","value":"Urate-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"sample_size","value":"n=125505","value_numeric":125505},{"paper_doi":"10.1002/acr.80086","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"study_design","value":"Population-Based Cohort Study","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"warning","value":"Administrative health data was used for diagnosis ascertainment — gout coding accuracy is not validated within this paper.","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"warning","value":"Colchicine and allopurinol are inferred as likely flare/ULT medications studied in the ≥66 age group; specific drug names are not listed in the abstract.","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"warning","value":"The study is limited to Ontario, Canada; findings may not generalize to other health systems with different access structures or demographics.","value_numeric":null}],"summaries":{"what_studied":"A population-based study of 125,505 ED visits for gout in Ontario, Canada (2014–2023), examining patient characteristics, encounter rate trends, health care use surrounding ED visits, and gout-related medication use in adults aged ≥66 years.","key_result":"ED gout visits peaked in 2018 at 0.99/1,000 persons (male-specific: 1.56/1,000). Within 30 days of discharge, only 21.3% had gout-specific follow-up, 10.3% filled an opioid prescription, and just 28.3% of older adults received flare medications. By 6 months, only 38.1% had serum urate testing. Within 90 days, 29.9% returned to the ED, with 9.4% specifically for gout.","limitations":"Medication data was only available for patients aged ≥66 years, limiting generalizability of treatment patterns to younger adults. The study is observational and population-based, so causal inference is not possible. Gout diagnosis coding in administrative data may misclassify some cases.","practice_takeaway":"Most gout patients discharged from the ED receive inadequate follow-up and urate-lowering therapy monitoring — clinicians should prioritize structured post-ED care pathways, including timely rheumatology or primary care follow-up and serum urate testing. The high opioid prescription rate (10.3% within 30 days) signals a quality gap that warrants intervention."}},{"doi":"10.1001/jamadermatol.2025.4240","pmid":"41160012","title":"HLA-B*58:01 and Risk of Allopurinol-Induced Severe Cutaneous Adverse Reactions in the US","journal_title":"JAMA Dermatology","journal_issn":"2168-6068","published_at":"2025-10-29T00:00:00.000Z","url":"https://doi.org/10.1001/jamadermatol.2025.4240","source_score":278,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-19","doi":"10.1001/jamadermatol.2025.4240","days":"30","issn":"2168-6068","rank":"1","field":"Clinical Medicine","score":"278","category":"Dermatology","categories":["Dermatology"],"_categories":["Dermatology"]},"pubmed":{"doi":"10.1001/jamadermatol.2025.4240","title":"HLA-B*58:01 and Risk of Allopurinol-Induced Severe Cutaneous Adverse Reactions in the US.","journal":"JAMA dermatology","methods":"","results":"This genetic association study used conditional logistic regression analyses and included 16 patients with allopurinol-induced SCAR (mean [SD] age, 61.1 [12.6] years; 9 female patients [56.25%] and 7 male patients [43.75%]) and 160 allopurinol-tolerant control participants matched 10:1. Two HLA class I alleles were found to be independently associated with increased risk of allopurinol-induced SCAR: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). No HLA class II alleles meeting the Bonferroni-corrected P < .05 level of significance were identified.","abstract":"$30","keywords":[],"pubmed_id":"41160012","conclusions":"","publication_date":"2025-10-29T00:00:00"},"crossref":{"DOI":"10.1001/jamadermatol.2025.4240","URL":"https://doi.org/10.1001/jamadermatol.2025.4240","ISSN":["2168-6068"],"link":[{"URL":"https://jamanetwork.com/journals/jamadermatology/articlepdf/2840445/jamadermatology_campbell_2025_br_250010_1765313940.3825.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1258","type":"journal-article","issue":"12","score":1,"title":["HLA-B*58:01 and Risk of Allopurinol-Induced Severe Cutaneous Adverse Reactions in the US"],"author":[{"given":"Chelsea N.","family":"Campbell","sequence":"first","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":"Matthew S.","family":"Krantz","sequence":"additional","affiliation":[{"name":"Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":"Alexis","family":"Yu","sequence":"additional","affiliation":[{"name":"Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":"Elizabeth J.","family":"Phillips","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee"},{"name":"Center for Drug Safety and Immunology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee"}]},{"given":null,"family":null,"sequence":"additional","affiliation":[]},{"given":"Roni","family":"Dodiuk Gad","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Aaron","family":"Drucker","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Elizabeth","family":"Ergen","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Rama","family":"Gangula","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Michelle","family":"Goh","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Benjamin","family":"Kaffenberger","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Dana","family":"King","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Rebecca","family":"Lee","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Kelby","family":"Mahan","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Michelle","family":"Martin-Pozo","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) Survivor Study Collaborators"}]},{"given":"Robert","family":"Micheletti","sequence":"additional","affiliation":[{"name":"for the Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis 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Collaborators"}]}],"issued":{"date-parts":[[2025,12,1]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":"161","created":{"date-time":"2025-10-29T15:32:33Z","timestamp":1761751953000,"date-parts":[[2025,10,29]]},"indexed":{"date-time":"2025-12-17T16:02:54Z","timestamp":1765987374645,"date-parts":[[2025,12,17]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamadermatology/fullarticle/2840445"}},"subtitle":[],"deposited":{"date-time":"2025-12-17T16:00:43Z","timestamp":1765987243000,"date-parts":[[2025,12,17]]},"issn-type":[{"type":"print","value":"2168-6068"}],"published":{"date-parts":[[2025,12,1]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1073/pnas.0409500102","key":"dbr250010r1","year":"2005","issue":"11","author":"Hung","volume":"102","first-page":"4134","unstructured":null,"article-title":"HLA-B*5801 allele as a genetic marker for severe cutaneous adverse 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Study","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.4240","tag_type":"warning","value":"Case count is very small (n=16), yielding wide CIs around effect estimates.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.4240","tag_type":"warning","value":"Controls relied on imputed HLA data from a single biobank, which may affect allele-calling accuracy.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2025.4240","tag_type":"warning","value":"Population-control sample size and matching details are not provided in the excerpt.","value_numeric":null}],"summaries":{"what_studied":"A US genetic case-control study (2015-2024) assessed whether HLA class I/II alleles are associated with allopurinol-induced severe cutaneous adverse reactions (SJS/TEN or DRESS) by comparing 16 adjudicated cases with matched allopurinol-tolerant and population controls.","key_result":"Two HLA class I alleles showed independent associations with allopurinol-induced SCAR: HLA-B*58:01 (OR 28.0, 95% CI 8.6-100.6) and HLA-A*34:02 (OR 20.6, 95% CI 3.3-131.1); no class II allele met Bonferroni-corrected significance. HLA-B*58:01 was absent in more than one-third of cases, indicating incomplete sensitivity.","limitations":"Very small case sample (n=16) with wide confidence intervals. Controls from a single biobank used imputed HLA typing, which may reduce allele-calling accuracy.","practice_takeaway":"HLA-B*58:01 remains a strong risk marker for allopurinol-induced SCAR in US patients, but testing alone will miss many at-risk patients. HLA-A*34:02 emerged as a second independent risk allele and warrants replication before informing routine screening."}}],"initialOffset":6,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"generic","value":"allopurinol"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Generics","href":"/hub/tag/generic"},{"name":"allopurinol"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"generic","hub_tag_value":"allopurinol"}}}]]

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