Genotypic and Phenotypic Characteristics of Co-Trimoxazole-Induced Cutaneous Adverse Reactions
Issued Date
2023-01-01
Resource Type
ISSN
10188665
eISSN
14219832
Scopus ID
2-s2.0-85178575264
Pubmed ID
37793359
Journal Title
Dermatology
Start Page
966
End Page
975
Rights Holder(s)
SCOPUS
Bibliographic Citation
Dermatology (2023) , 966-975
Suggested Citation
Iamsumang W., Chanprapaph K., Sukasem C., Satapornpong P., Thadanipon K., Suchonwanit P., Jantararoungtong T., Anuntrangsee T. Genotypic and Phenotypic Characteristics of Co-Trimoxazole-Induced Cutaneous Adverse Reactions. Dermatology (2023) , 966-975. 975. doi:10.1159/000534342 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/91484
Title
Genotypic and Phenotypic Characteristics of Co-Trimoxazole-Induced Cutaneous Adverse Reactions
Author's Affiliation
Other Contributor(s)
Abstract
Background: Co-trimoxazole has been reported as a common culprit drug for various cutaneous adverse drug reactions (CADRs). However, information on genotypic and phenotypic characteristics is still limited. We aimed to study clinical characteristics, genetic suitability, laboratory findings, and treatment outcomes in patients with co-trimoxazole-induced CADR and determine variables associated with severe cutaneous adverse reactions (SCARs). Methods: The medical records of all patients diagnosed with co-trimoxazole-induced CADR during October 2015 and October 2021 were reviewed. Clinical characteristics and laboratory investigation with an emphasis on human leukocyte antigen (HLA) class I and HLADRB1 results linked to subtypes of cutaneous adverse reactions were evaluated. Results: Seventy-two patients diagnosed with co-trimoxazole-induced CADR were included in the study. Mean age at diagnosis was 38.0 ± 14.6 years old, and 72% were female. Subtypes of reactions included maculopapular eruption (MPE; 56.9%), drug reaction with eosinophilia and systemic symptoms (DRESS; 23.6%), Stevens-Johnson syndrome (SJS; 12.5%), fixed drug eruption (4.2%), and urticaria (2.8%). Characteristics that were significantly associated with SCARs included male gender (OR = 3.01, 95% CI: 1.04–8.75), HIV infection (OR = 3.48, 95% CI: 1.13–10.75), prophylactic use of co-trimoxazole (OR = 4.89, 95% CI: 1.54–15.57), and cotrimoxazole administration longer than 10 days (OR = 7.65, 95% CI: 2.57–22.78). HLA-B*38:02 was associated with cotrimoxazole-induced SJS, while HLA-A*11:01, HLA-B*13:01, and HLA-DRB1*12:01 were associated with co-trimoxazole-induced DRESS. HLA-B*52:01 was associated with cotrimoxazole-induced MPE. Conclusions: Co-trimoxazole could induce various phenotypes of CADRs. Genotypic and phenotypic factors that may potentially predict cotrimoxazole-induced SCARs include male gender, HIV infection, prophylactic and prolonged drug use, as well as the presence of HLA-A*11:01, HLA-B*13:01, HLA-B*38:02, or HLADRB1*12:01 alleles.
