Pharmacogenetics of adverse cutaneous reactions to lamotrigine

Abstract

Cutaneous adverse drug reactions include maculopapular exanthema, Stevens-Johnson syndrome, and toxic epidermal necrolysis and are a global public health problem associated with the use of antiepileptic drugs. Lamotrigine stands out among antiepileptic drugs because it does not cause sedation and does not affect cognition. Cutaneous adverse reactions to lamotrigine occur in patients carrying certain allele variants of the HLA system; although infrequent, they are alarming because they put the life at risk and force discontinuation of the treatment. The fear of neurologists to cutaneous adverse reactions to lamotrigine decreases its prescription despite its therapeutic advantages. Here we review the allele variants of the HLA system that have been associated with cutaneous adverse reactions to lamotrigine in Mexican mestizos and other ethnic groups; identification of these variants would serve to select the patients that may be treated with lamotrigine.