Temporal trends and patterns in carbamazepine use, related severe cutaneous adverse reactions, and HLA ‐B*15:02 screening: A nationwide study

SummaryObjectiveAfter discovering the association between the HLA ‐B*15:02 allele and carbamazepine‐related severe cutaneous adverse reactions (SCARs), particularly in Southeastern Asian populations, clinical strategies to prevent carbamazepine‐related SCARs have changed. We aimed to investigate 10‐year trends in carbamazepine use and carbamazepine‐relat ed SCARs and to examine the patterns and determinants of HLA‐B*15:02 screening in Taiwan.MethodsA nationwide study was performed using Taiwan ’s National Health Insurance Research Database. In the first part of the study, new users of carbamazepine were included, and those who experienced SCAR‐related admissions were further identified. In the second part of the study, recipients of HLA‐B*15:02 screening (reimbursed by Taiwan’s Na tional Health Insurance since June 2010) were included and multivariate logistic regression was used to explore factors associated with the use of screening.ResultsThe numbers of new users of carbamazepine and SCAR cases decreased remarkably during the 10 ‐year period (−82.6% and −87.1%, respectively), and the incidence rates of SCARs showed a downward trend after 2011. The screening rate of the HLA‐B*15:02 allele increased to 24.9% in 2014. Neurologists (odds ratio 12.33, 95% confidence interval 9.30‐16.35), psychiatrists (9.97, 7.31‐13. 61), and neurosurgeons (3.23, 2.42‐4.32) were more likely to perform screening tests than other specialties were. Physicians prac...
Source: Epilepsia - Category: Neurology Authors: Tags: FULL ‐LENGTH ORIGINAL RESEARCH Source Type: research