Patient, Disease, and Drug-Related Risk Factors Associated with Pheny-toin-Induced Cutaneous Adverse Drug Reactions in South Indian Epileptic Patients-A Prospective Case-Control Study
Issued Date
2022-08-01
Resource Type
ISSN
15748863
Scopus ID
2-s2.0-85129527502
Pubmed ID
34792004
Journal Title
Current Drug Safety
Volume
17
Issue
3
Start Page
241
End Page
249
Rights Holder(s)
SCOPUS
Bibliographic Citation
Current Drug Safety Vol.17 No.3 (2022) , 241-249
Suggested Citation
John S., Canyuk B., Anand T.C.V., Sukasem C., Pat-Tharachayakul S. Patient, Disease, and Drug-Related Risk Factors Associated with Pheny-toin-Induced Cutaneous Adverse Drug Reactions in South Indian Epileptic Patients-A Prospective Case-Control Study. Current Drug Safety Vol.17 No.3 (2022) , 241-249. 249. doi:10.2174/157488631602211118122907 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85691
Title
Patient, Disease, and Drug-Related Risk Factors Associated with Pheny-toin-Induced Cutaneous Adverse Drug Reactions in South Indian Epileptic Patients-A Prospective Case-Control Study
Author's Affiliation
Other Contributor(s)
Abstract
Background: Phenytoin is the most commonly reported aromatic Anti-Epileptic Drug (AED) to cause Cutaneous Adverse Drug Reactions (CADRs). Cutaneous adverse drug reactions may be immune or non-immune mediated. It has been observed that predisposition is multifactorial and that gene mutations alone cannot be the cause. Objectives: In this study, we investigated the patient, disease, and drug-related risk factors associated with phenytoin-induced cutaneous adverse drug reactions in South Indian epileptic patients. Methods: This study was conducted as a single-center prospective case-control study over a period of 13 months. The Fisher’s exact test and multivariate binary logistic regression analysis were used to test the association of single and multiple variables, respectively. Results: This study comprised 26 patients with phenytoin-induced cutaneous adverse drug reactions (PHT-CARDs) and 32 phenytoin-tolerant controls with a mean age of 40.60±18.15 and 36.21±14.71 years, respectively. Among 26 phenytoin-induced cutaneous adverse drug reactions, 76.92% cases were mild-moderate reactions and 23.07% were severe. The onset latency period of these reactions ranged from 7-42 days. The multivariate analysis showed that multiple AEDs (OR =18.62, 95% CI 4.28-80.87, p=< .001) and comorbidities (OR= 5.98, 95% CI 1.33-26.78, p=.01) are risk factors for PHT-CADRs. PHT-SCARs were shown to be associated with previous allergy history (OR= 31, % CI 2.40-398.8, p=.008). Conclusion: The risk factors found to be associated with CARDs in South Indian Epileptic patients are multiple AEDs, comorbidities, and past allergic history. Therefore, physicians and other associated health care professionals should closely monitor the patients when phenytoin is em-ployed.