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Genotyping for HLA antigens like HLA-B *5801 is recommended before initiating allopurinol therapy in hyperuricemic patients. This was due to Allopurinol induced cutaneous adverse reactions (CARs) reported in certain populations. In certain cases hypersensitivity syndrome with epidermal necrolysis with hepatic and renal failure are observed in allpurinol treat patients. CARs are reported to be a great concern following Allopurinol therapy, alternative drugs like febuxostat that could inhibit xanthine oxidase activity are being tried.1-2With fewer drugs to treat patients with Gout it will be prudent to do genotype analyses of specific HLA antigens known to be associated with such CARs. Cases like these seem to suggest that Pharmacogenomics may become one of the key elements in future drug therapy.3 Uric acid is now considered as a risk factor cardiovascular diseases as well as a prooxidant. Prudence must play an important role in prescribing drugs with know side effects.
1.Lin CW, Huang W, Chao PH, Chen WW, Hsiao FY. Risk of cutaneous adverse reactions associated with allopurinol or febuxostat in real-world patients: A nationwide study. Int J Clin Pract. 2019 May;73(5):e13316. doi: 10.1111/ijcp.13316. Epub 2019 Feb 28.
2. http://www.hsa.gov.sg/DHCPL
3. Pharmacogenomics, 2015 16: 1781-93