Genetic tests may miss reaction risk from drug prescribed to millions
A genetic marker already used to flag the risk of a life-threatening reaction to the antibiotic vancomycin also identifies patients at risk of that reaction to lamotrigine—and it is missing from the gene panels clinicians order before prescribing the drug, Vanderbilt Health-led researchers report in JAMA Network Open. The two variants those panels do test for showed no association with…
Researchers led by Vanderbilt Health found that a genetic marker already used to identify patients at risk of a life-threatening reaction to the antibiotic vancomycin can also predict the risk of a similar reaction to the antiepileptic drug lamotrigine. This marker, HLA-A*32:01, was not included in the gene panels clinicians typically order before prescribing lamotrigine.
The marker is present in nearly 16% of patients who develop DRESS (drug reaction with eosinophilia and systemic symptoms) from lamotrigine, compared to only 4% of those who do not experience the reaction. HLA-A*32:01 testing could potentially identify some patients at risk, but negative results do not rule out the possibility of a reaction.
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