{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:01:56Z","timestamp":1790614916678,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,11,26]],"date-time":"2018-11-26T00:00:00Z","timestamp":1543190400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009210","name":"Food and Drug Administration","doi-asserted-by":"publisher","award":["MOHW 106\u2010FDA\u2010D\u2010113\u2010000411 and MOHW 107\u2010FDA\u2010D\u2010113\u20100"],"award-info":[{"award-number":["MOHW 106\u2010FDA\u2010D\u2010113\u2010000411 and MOHW 107\u2010FDA\u2010D\u2010113\u20100"]}],"id":[{"id":"10.13039\/100009210","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>After discovering the association between the <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010B*15:02 allele and carbamazepine\u2010related severe cutaneous adverse reactions (<jats:styled-content style=\"fixed-case\">SCAR<\/jats:styled-content>s), particularly in Southeastern Asian populations, clinical strategies to prevent carbamazepine\u2010related <jats:styled-content style=\"fixed-case\">SCAR<\/jats:styled-content>s have changed. We aimed to investigate 10\u2010year trends in carbamazepine use and carbamazepine\u2010related <jats:styled-content style=\"fixed-case\">SCAR<\/jats:styled-content>s and to examine the patterns and determinants of <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010B*15:02 screening in Taiwan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nationwide study was performed using Taiwan\u2019s National Health Insurance Research Database. In the first part of the study, new users of carbamazepine were included, and those who experienced <jats:styled-content style=\"fixed-case\">SCAR<\/jats:styled-content>\u2010related admissions were further identified. In the second part of the study, recipients of <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010B*15:02 screening (reimbursed by Taiwan\u2019s National Health Insurance since June 2010) were included and multivariate logistic regression was used to explore factors associated with the use of screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The numbers of new users of carbamazepine and <jats:styled-content style=\"fixed-case\">SCAR<\/jats:styled-content> cases decreased remarkably during the 10\u2010year period (\u221282.6% and \u221287.1%, respectively), and the incidence rates of <jats:styled-content style=\"fixed-case\">SCAR<\/jats:styled-content>s showed a downward trend after 2011. The screening rate of the <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010B*15:02 allele increased to 24.9% in 2014. Neurologists (odds ratio 12.33, 95% confidence interval 9.30\u201016.35), psychiatrists (9.97, 7.31\u201013.61), and neurosurgeons (3.23, 2.42\u20104.32) were more likely to perform screening tests than other specialties were. Physicians practicing in medical centers (6.00, 5.51\u20106.54) were more likely to perform screening tests than those practicing in other hospitals, whereas the screening rates in clinics remained at 0.0% throughout the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>In recent years, the number of carbamazepine\u2010related <jats:styled-content style=\"fixed-case\">SCAR<\/jats:styled-content> cases has decreased substantially in Taiwan. However, only one\u2010fourth of new users of carbamazepine received <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010B*15:02 screening, and there were considerable disparities in the screening rates across different physician groups. Policymakers should consider solutions to barriers to implementing screening tests in clinical practice and should not neglect the value of other safety communications and regulations to complement the limitations of pharmacogenomic testing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.14599","type":"journal-article","created":{"date-parts":[[2018,11,27]],"date-time":"2018-11-27T05:04:50Z","timestamp":1543295090000},"page":"2325-2339","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Temporal trends and patterns in carbamazepine use, related severe cutaneous adverse reactions, and <scp>HLA<\/scp>\u2010B*15:02 screening: A nationwide study"],"prefix":"10.1111","volume":"59","author":[{"given":"Chih\u2010Wan","family":"Lin","sequence":"first","affiliation":[{"name":"Taiwan Drug Relief Foundation Taipei  Taiwan"},{"name":"Graduate Institute of Clinical Pharmacy College of Medicine National Taiwan University Taipei  Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010I","family":"Huang","sequence":"additional","affiliation":[{"name":"Taiwan Drug Relief Foundation Taipei  Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pi\u2010Hui","family":"Chao","sequence":"additional","affiliation":[{"name":"Taiwan Drug Relief Foundation Taipei  Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Taiwan Drug Relief Foundation Taipei  Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei\u2010Yuan","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Graduate Institute of Clinical Pharmacy College of Medicine National Taiwan University Taipei  Taiwan"},{"name":"School of Pharmacy College of Medicine National Taiwan University Taipei  Taiwan"},{"name":"Department of Pharmacy National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2009.07.005"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30378-6"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332404"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5701033"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.510"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2295"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.08.009"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31823b478c"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/428486a"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2007.01022.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2008.01719.x"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/0378-6323.57718"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2010.04745.x"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.5415\/apallergy.2015.5.2.68"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2012.189"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.683"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2217\/14622416.9.10.1543"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e318245a160"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009717"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001034"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.3540"},{"key":"e_1_2_9_23_1","first-page":"99","article-title":"Using Taiwan\u2019s national health insurance research databases for pharmacoepidemiology research","volume":"15","author":"Hsiao FY","year":"2007","journal-title":"J Food Drug Anal"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.3536"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.13883"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1001\/2012.jama.11975"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003453"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200831080-00006"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlr.0000182534.19832.83"},{"key":"e_1_2_9_30_1","unstructured":"Ministry of Health and Welfare.Hospital accreditation. 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