Department of Pharmacology, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
Naunyn Schmiedebergs Arch Pharmacol. 2023 Nov;396(11):3177-3182. doi: 10.1007/s00210-023-02525-2. Epub 2023 May 18.
The link between human leukocyte antigen (HLA) alleles and carbamazepine-induced cutaneous, respiratory, and gastrointestinal adverse drug reactions (ADR) has created a window of opportunity for preventing certain forms of cutaneous adverse drug reactions (cADRs); however, there is not enough data to make pharmacogenomic recommendations that can be implemented globally. The aim of this study is to assess and document carbamazepine-induced adverse reactions among prescribed Saudi/non-Saudi patients. A retrospective chart review was performed for patients who received carbamazepine (CBZ) in the period between 2016 and 2020, in the Kingdom of Saudi Arabia. Data were gathered and descriptive statistical analyses were performed on the data for the study sample. Comparisons were made using the chi-square test or independent samples' t-test. Statistical significance was considered at p < .05. All statistical analyses were performed using IBM SPSS 21.0 (Armonk, NY; IBM Corp). Results from multivariate logistic regression analyses showed that higher likelihood of carbamazepine-induced adverse reactions was significantly associated with younger age, OR = 0.82, 95% CI (0.74, 0.90); p < 0.001. Patients who were prescribed CBZ for reasons other than epilepsy or seizures were significantly more likely to develop carbamazepine-induced adverse reactions (epilepsy vs. other; OR = 0.63, p = 0.013; seizures vs. other; OR = 0.59, p = 0.018). Gender or medication duration were not related to carbamazepine-induced adverse reactions (p > 0.05). The findings of this study are comparable with those of other studies assessing carbamazepine-associated adverse reactions in children and adults. Recommendations include genetic prescreening, educating patients and parents on the possibility of adverse reactions, and routine laboratory monitoring.
人类白细胞抗原（HLA）等位基因与卡马西平诱导的皮肤、呼吸和胃肠道不良反应（ADR）之间的联系为预防某些形式的皮肤不良反应（cADR）提供了机会；然而，没有足够的数据来制定可以在全球实施的药物基因组学建议。本研究旨在评估和记录在沙特/非沙特患者中规定使用卡马西平（CBZ）时发生的不良反应。对 2016 年至 2020 年期间在沙特阿拉伯王国接受卡马西平（CBZ）治疗的患者进行了回顾性病历审查。收集数据并对研究样本的数据进行描述性统计分析。使用卡方检验或独立样本 t 检验进行比较。统计显著性定义为 p < 0.05。所有统计分析均使用 IBM SPSS 21.0（Armonk，NY；IBM 公司）进行。多变量逻辑回归分析的结果表明，卡马西平诱导不良反应的可能性更高与年龄较小显著相关，OR=0.82，95%CI（0.74，0.90）；p<0.001。因癫痫或癫痫以外的原因开处方 CBZ 的患者发生卡马西平诱导不良反应的可能性显著更高（癫痫与其他；OR=0.63，p=0.013；癫痫与其他；OR=0.59，p=0.018）。性别或药物持续时间与卡马西平诱导的不良反应无关（p>0.05）。本研究的结果与其他评估儿童和成人卡马西平相关不良反应的研究结果相当。建议包括基因预筛查、向患者和家长教育不良反应的可能性，以及常规实验室监测。
