Pharmacogenetics Gout and Allopurinol Hypersensitivity
Keywords:
pharmacogenetics, gout, Allopurinol Hypersensitivity, HLA B*58:01Abstract
Allopurinol is the primary drug for hyperuricemia and gout treatment, acting on the reduction of blood uric acid levels. Adverse reactions to Allopurinol have been reported worldwide, including in Thailand. The hypersensitivity is genetically related. Currently, Thai National Health Security Board B.E. 2021 has issued an announcement supporting the genetic screening of the Human Leukocyte Antigen-B*58:01 (HLA-B*58:01) allele before prescribing Allopurinol to new gout patients. Since the research results found an association between Allopurinol hypersensitivity and the HLA-B*58:01 allele, which is found in 16.33% of the Thai population, this allele screening test has 100 percent sensitivity and 96 percent specificity, thus helping to avoid Severe Cutaneous Adverse Reactions--SCARs. This review provides information on the pharmacology of Allopurinol, Hyperuricemia, and Gout, Adverse Drug Reactions--ADRs, prevention of ADRs by pharmacogenetics to raise awareness about the harm of Allopurinol hypersensitivity, and pharmacogenetics analysis guidelines to prevent Allopurinol hypersensitivity risk.
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