1. HLA-B*38:02:01predicts carbimazole/methimazole-induced agranulocytosis
- Author
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Ay Ho, Munir Pirmohamed, Kmk Chan, MW Mak, Jy Leung, Chor-Wing Sing, Vivian W.Y. Tam, CS Hung, KF Lee, Tak Wai Wong, Pak C. Sham, Vincent Ka-Fai Cheng, Clara S. Tang, Ian C. K. Wong, CH Choi, WZ Wat, Ey Lau, CT Chung, Bernard M.Y. Cheung, HK Pang, SC Siu, Awc Kung, Ching-Lung Cheung, HH Lee, V Hung, RS Hue, and Kathryn C.B. Tan
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Linkage disequilibrium ,Carbimazole ,medicine.medical_treatment ,Genome-wide association study ,Polymorphism, Single Nucleotide ,Gastroenterology ,Linkage Disequilibrium ,03 medical and health sciences ,0302 clinical medicine ,Antithyroid Agents ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Pharmacology ,Methimazole ,business.industry ,Antithyroid agent ,Case-control study ,Odds ratio ,Drug-induced agranulocytosis ,030104 developmental biology ,Endocrinology ,HLA-B Antigens ,Propylthiouracil ,Case-Control Studies ,030220 oncology & carcinogenesis ,Female ,business ,Agranulocytosis ,Genome-Wide Association Study ,medicine.drug - Abstract
© 2015, The American Society for Clinical Pharmacology and Therapeutics.Thioamides antithyroid-drugs (ATDs) are important in hyperthyroid disease management. Identification of the susceptibility locus of ATD-induced agranulocytosis is important for clinical management. We performed a genome-wide association study (GWAS) involving 20 patients with ATD-induced agranulocytosis and 775 healthy controls. The top finding was further replicated. A single-nucleotide polymorphism (SNP), rs185386680, showed the strongest association with ATD-induced agranulocytosis in GWAS (odds ratio (OR) = 36.4; 95% confidence interval (CI) = 12.8-103.7; P = 1.3 × 10 -24) and replication (OR = 37; 95% CI = 3.7-367.4; P = 9.6 × 10 -7). HLA-B∗38:02:01 was in complete linkage disequilibrium with rs185386680. High-resolution HLA typing confirmed that HLA-B∗38:02:01 was associated with carbimazole (CMZ)/methimazole (MMI)-induced agranulocytosis (OR = 265.5; 95% CI = 27.9-2528.0; P = 2.5 × 10 -14), but not associated with propylthiouracil (PTU). The positive and negative predictive values of HLA-B∗38:02:01 in predicting CMZ/MMI-induced agranulocytosis were 0.07 and 0.999. Approximately 211 cases need to be screened to prevent one case. Screening for the risk allele will be useful in preventing agranulocytosis in populations in which the frequency of the risk allele is high.
- Published
- 2016
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