HLA‐B*38:02:01 predicts carbimazole/methimazole‐induced agranulocytosis



Cheung, CL, Sing, CW, Tang, CSM, Cheng, VKF, Pirmohamed, M ORCID: 0000-0002-7534-7266, Choi, CH, Hung, CS, Lau, EYF, Lee, KF, Mak, MWH
et al (show 17 more authors) (2016) HLA‐B*38:02:01 predicts carbimazole/methimazole‐induced agranulocytosis. Clinical Pharmacology and Therapeutics, 99 (5). pp. 555-561.

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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.

Item Type: Article
Uncontrolled Keywords: Humans, Agranulocytosis, Methimazole, Carbimazole, Propylthiouracil, Antithyroid Agents, HLA-B Antigens, Case-Control Studies, Predictive Value of Tests, Linkage Disequilibrium, Polymorphism, Single Nucleotide, Female, Genome-Wide Association Study
Depositing User: Symplectic Admin
Date Deposited: 06 May 2016 08:06
Last Modified: 19 Jan 2023 07:37
DOI: 10.1002/cpt.309
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3001093