{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:19:19Z","timestamp":1788668359270,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T00:00:00Z","timestamp":1690934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG3M0021"],"award-info":[{"award-number":["CMRPG3M0021"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG3M0022"],"award-info":[{"award-number":["CMRPG3M0022"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG3M0023"],"award-info":[{"award-number":["CMRPG3M0023"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The HLA\u2010B*1502 allele is strongly associated with carbamazepine (CBZ)\u2010induced Stevens\u2013Johnson syndrome\/toxic epidermal necrolysis (SJS\/TEN) in the Han Chinese population. This study investigated the impact of HLA\u2010B*1502 screening on CBZ utilization and rates of severe cutaneous allergic reactions (SCARs) and SJS\/TEN over time in Taiwan, where screening for HLA\u2010B*1502 genotyping before prescribing CBZ was reimbursed in June 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the Taiwan National Health Insurance Research Database, we analyzed 13\u2009277\u2009457 episodes of seeking treatment for epilepsy or neuralgia between 2000 and 2017. Episodes were categorized into quarters based on treatment time. Propensity score\u2010based stabilized weighting (PSSW) ensured well\u2010balanced covariates. The difference in 3\u2010month SCAR and SJS\/TEN rates between phase 2 (2011\u20132017) and phase 1 (2000\u20132009) was examined using a one\u2010sample <jats:italic>Z<\/jats:italic>\u2010test. Pearson correlation coefficients assessed the association between screening rate, the number of CBZ users and nonusers, and SCAR and SJS\/TEN rates after HLA\u2010B*1502 genotyping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CBZ prescriptions reduced from 7% (2000\u20132003) to 6% (2004\u20132010) and 4% (2011\u20132017). The screening rates of CBZ nonusers and CBZ users increased from 0%, .5% in 2011 to .8%, 16% in 2017, respectively. After PSSW, the mean 3\u2010month SCAR incidence rates (per 10\u2009000 episodes) significantly decreased from phase 1 to phase 2 for CBZ users (6.91 vs. 3.09, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) and nonusers (1.96 vs. 1.65, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). SJS\/TEN incidence rates (per 10\u2009000 episodes) significantly decreased from phase 1 to phase 2 for CBZ users (2.94 vs. 1.93, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001) but not for nonusers (.71 vs. .74, <jats:italic>p<\/jats:italic>\u2009=\u2009.1492). In phase 2, SCAR incidence rates were significantly and negatively correlated with the screening rate for both CBZ users (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.38, <jats:italic>p<\/jats:italic>\u2009=\u2009.0342) and nonusers (<jats:italic>r<\/jats:italic>\u2009=\u2009\u2212.80, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). No significant correlation was found between SJS\/TEN incidence rates and screening rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Recognizing HLA\u2010B*1502 allele and avoiding CBZ therapy in HLA\u2010B*1502\u2010positive patients is critical for preventing CBZ\u2010induced severe adverse events.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17726","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T17:38:37Z","timestamp":1690565917000},"page":"2679-2689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact on carbamazepine usage and cutaneous adverse reactions before and after the reimbursement of HLA\u2010B*1502 genotyping in Taiwan, 2000\u20132017: A nationwide longitudinal study"],"prefix":"10.1111","volume":"64","author":[{"given":"Bao\u2010Luen","family":"Chang","sequence":"first","affiliation":[{"name":"Department of Neurology Chang Gung Memorial Hospital at Linkou  Taoyuan City Taiwan"},{"name":"School of Medicine, College of Medicine Chang Gung University  Taoyuan City Taiwan"},{"name":"Neuroscience Research Center Chang Gung Memorial Hospital at Linkou  Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Rou","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine Chang Gung University  Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Hao","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine Chang Gung University  Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1379-8969","authenticated-orcid":false,"given":"Lai\u2010Chu","family":"See","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Medicine Chang Gung University  Taoyuan City Taiwan"},{"name":"Biostatistics Core Laboratory, Molecular Medicine Research Center Chang Gung University  Taoyuan City Taiwan"},{"name":"Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine Chang Gung Memorial Hospital at Linkou  Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/428486a"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1990.01670250049006"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31821201ed"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.2217\/17410541.2.3.225"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332404"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.8.1019"},{"issue":"2","key":"e_1_2_11_8_1","first-page":"95","article-title":"Cutaneous adverse drug reactions: clinical pattern and causative agents \u2013 a 6 year series from Chandigarh, India","volume":"47","author":"Sharma VK","year":"2001","journal-title":"J Postgrad Med"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0305-4179(95)00140-9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-4362.1998.00490.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-013-9777-9"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)05418-X"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.2217\/pgs-2017-0103"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13812"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00251-017-1007-5"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2017.05.015"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30378-6"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2332\/allergolint.10-RAI-0261"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.4114"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2012.510"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2295"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2012.08.009"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2217\/14622416.9.10.1543"},{"key":"e_1_2_11_24_1","unstructured":"National Health Insurance Annual Report 2021\u20132022. 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