{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:23:19Z","timestamp":1791912199572,"version":"4.3.4"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>\n                    Extensive scientific evidence consistently demonstrates the clinical validity and utility of\n                    <jats:italic toggle=\"yes\">HLA-B*15:02<\/jats:italic>\n                    pre-screening in averting severe cutaneous adverse reactions (SCARs), namely Stevens-Johnson syndrome and toxic epidermal necrolysis, associated with carbamazepine or oxcarbazepine usage. Current practice guidelines and drug labeling actively advocate for pharmacogenetic pre-screening before initiating these antiepileptic drugs (AED), with particular emphasis on patients of Asian descent. However, there is a potential need to strengthen compliance with these recommendations. This retrospective study aimed to describe the pharmacogenetic pre-screening, documentation, and SCARs incidence for patients of Asian ancestry initiated on carbamazepine or oxcarbazepine at a large Northeastern USA healthcare system. Between 1 July 2016 and August 1, 2021, 27 patients with documented Asian heritage in the electronic health record (EHR) were included. The overall rate of\n                    <jats:italic toggle=\"yes\">HLA-B*15:02<\/jats:italic>\n                    pre-screening before carbamazepine or oxcarbazepine initiation was 4%. None who underwent pharmacogenetic pre-screening carried the associated\n                    <jats:italic toggle=\"yes\">HLA-B<\/jats:italic>\n                    risk allele, and no SCARs were reported. Notably, pharmacogenetic results were not discretely entered into the EHR, and the results were only found as attached documents in the miscellaneous section of the EHR. There remains a significant opportunity for improving\n                    <jats:italic toggle=\"yes\">HLA-B*15:02<\/jats:italic>\n                    pre-screening for patients starting carbamazepine and oxcarbazepine to prevent SCARs in the USA.\n                  <\/jats:p>","DOI":"10.1097\/fpc.0000000000000510","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T10:00:34Z","timestamp":1697191234000},"page":"16-19","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Pharmacogenetics to prevent hypersensitivity reactions to antiepileptic drugs: is testing performed when indicated?"],"prefix":"10.1097","volume":"34","author":[{"given":"Vy L.","family":"Bui","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Johns Hopkins Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Alvarez-Arango","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins University School of Medicine"},{"name":"Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine"},{"name":"Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M.","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins University School of Medicine"},{"name":"Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"R5-20250808","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1111\/epi.12564","article-title":"Recommendations for HLA-B*15:02 and HLA-A*31:01 genetic testing to reduce the risk of carbamazepine-induced hypersensitivity reactions.","volume":"55","author":"Amstutz","year":"2014","journal-title":"Epilepsia"},{"key":"R6-20250808","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1002\/cpt.1004","article-title":"Clinical pharmacogenetics implementation consortium guideline for HLA genotype and use of carbamazepine and oxcarbazepine: 2017 update.","volume":"103","author":"Phillips","year":"2018","journal-title":"Clin Pharmacol Ther"},{"key":"R7-20250808","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1146\/annurev-pharmtox-010818-021818","article-title":"Applications of immunopharmacogenomics: predicting, preventing, 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Pharmacol Ther"},{"key":"R11-20250808","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1002\/cpt.2387","article-title":"Pharmacogenomic clinical decision support: a review, how-to guide, and future vision.","volume":"112","author":"Wake","year":"2022","journal-title":"Clin Pharmacol Ther"},{"key":"R12-20250808","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1111\/epi.13925","article-title":"The risk of Stevens-Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptic drugs.","volume":"58","author":"Frey","year":"2017","journal-title":"Epilepsia"},{"key":"R13-20250808","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"R14-20250808","doi-asserted-by":"crossref","first-page":"527","DOI":"10.3389\/fphar.2020.00527","article-title":"Usage pattern of carbamazepine and associated severe cutaneous adverse reactions in Singapore following implementation of HLA-B*15:02 genotyping as standard-of-care.","volume":"11","author":"Sung","year":"2020","journal-title":"Front Pharmacol"},{"key":"R15-20250808","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1212\/WNL.0000000000001034","article-title":"Effects of a HLA-B*15:02 screening policy on antiepileptic drug use and severe skin reactions.","volume":"83","author":"Chen","year":"2014","journal-title":"Neurology"},{"key":"R16-20250808","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12981-019-0217-3","article-title":"HLA-B*57:01 screening and hypersensitivity reaction to abacavir between 1999 and 2016 in the OPERA\u00ae observational database: a cohort study.","volume":"16","author":"Mounzer","year":"2019","journal-title":"AIDS Res Ther"},{"key":"R17-20250808","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1136\/amiajnl-2013-001993","article-title":"Development and use of active clinical decision support for preemptive pharmacogenomics.","volume":"21","author":"Bell","year":"2014","journal-title":"J Am Med Inform Assoc"},{"key":"R18-20250808","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1093\/jamia\/ocac187","article-title":"Clinician adherence to pharmacogenomics prescribing recommendations in clinical decision support alerts.","volume":"30","author":"Nguyen","year":"2022","journal-title":"J Am Med Inform Assoc"},{"key":"R19-20250808","doi-asserted-by":"crossref","first-page":"3201","DOI":"10.1111\/bcp.15234","article-title":"Pharmacogenomic alerts: developing guidance for use by healthcare professionals.","volume":"88","author":"Carter","year":"2022","journal-title":"Br J Clin Pharmacol"},{"key":"R20-20250808","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1002\/ajmg.c.31385","article-title":"Adoption of a clinical pharmacogenomics implementation program during outpatient care--initial results of the University of Chicago \u20181,200 Patients Project\u2019.","volume":"166C","author":"O\u2019Donnell","year":"2014","journal-title":"Am J Med Genet C Semin Med Genet"},{"key":"R21-20250808","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1002\/phar.2196","article-title":"Abacavir hypersensitivity reaction reporting rates during a decade of HLA-B*5701 screening as a risk-mitigation measure.","volume":"39","author":"Stainsby","year":"2019","journal-title":"Pharmacotherapy"},{"key":"R22-20250808","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1111\/tan.13280","article-title":"High-resolution HLA allele and haplotype frequencies in majority and minority populations of Costa Rica and Nicaragua: differential admixture proportions in neighboring countries.","volume":"91","author":"Arrieta-Bola\u00f1os","year":"2018","journal-title":"HLA"},{"key":"R23-20250808","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1038\/nature15393","article-title":"A global reference for human genetic variation.","volume":"526","author":"Auton","year":"2015","journal-title":"Nature"},{"issue":"Database issue","key":"R24-20250808","doi-asserted-by":"crossref","first-page":"D784","DOI":"10.1093\/nar\/gku1166","article-title":"Allele frequency net 2015 update: new features for HLA epitopes, KIR and disease and HLA adverse drug reaction associations.","volume":"43","author":"Gonz\u00e1lez-Galarza","year":"2015","journal-title":"Nucleic Acids Res"}],"container-title":["Pharmacogenetics and 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