Abstract
HLA alleles, part of the major histocompatibility complex, are strongly associated with adverse drug reactions (ADRs). This review focuses on HLA-B*15:02 and explores its association with ADRs in various ethnic populations and with different drugs, aiming to provide insights into the safe clinical use of drugs and minimize the occurrence of ADRs. Furthermore, the review explores the potential mechanisms by which HLA-B*15:02 may be associated with ADRs, aiming to gain new insights into drug modification and identification of haptens. In addition, it analyzes the frequency of the HLA-B*15:02, genotyping methods, cost–effectiveness and treatment measures for adverse reactions, thereby providing a theoretical basis for formulating clinical treatment plans.
References
- 1. . The role of pharmacogenomics in adverse drug reactions. Expert Rev. Clin. Pharmacol. 12(5), 407–442 (2019).
- 2. . Immune pathomechanism and classification of drug hypersensitivity. Allergy 74(8), 1457–1471 (2019).
- 3. Current perspectives on severe drug eruption. Clin. Rev. Allergy Immunol. 61(3), 282–298 (2021).
- 4. GraphSAW: a web-based system for graphical analysis of drug interactions and side effects using pharmaceutical and molecular data. BMC Med. Inform. Decis. Mak. 15, 15 (2015).
- 5. . Pharmacogenetics of hypersensitivity drug reactions. Therapie 72(2), 231–243 (2017).
- 6. Genomic risk factors driving immune-mediated delayed drug hypersensitivity reactions. Front. Genet. 12, 641905 (2021).
- 7. Medical genetics: a marker for Stevens–Johnson syndrome. Nature 428(6982), 486 (2004).
- 8. . Carbamazepine, HLA-B*15:02 and risk of Stevens–Johnson syndrome and toxic epidermal necrolysis: US FDA recommendations. Pharmacogenomics 9(10), 1543–1546 (2008).
- 9. . Cross-reactivity pattern of rash from current aromatic antiepileptic drugs. Epilepsy Res. 80(2–3), 194–200 (2008).
- 10. Complete sequence and gene map of a human major histocompatibility complex. The MHC sequencing consortium. Nature 401(6756), 921–923 (1999).
- 11. . Human leukocyte antigen and tumor immunotherapy (Review). Int. J. Oncol. 62(6), 1–14 (2023).
- 12. The IPD-IMGT/HLA database. Nucleic Acids Res. 51(D1), D1053–D1060 (2023).
- 13. The IPD and IMGT/HLA database: allele variant databases. Nucleic Acids Res. 43(Database Issue), D423–D431 (2015).
- 14. . Global frequencies of clinically important HLA alleles and their implications for the cost-effectiveness of preemptive pharmacogenetic testing. Clin. Pharmacol. Ther. 109(1), 160–174 (2021).
- 15. HLA-B*15:02 association with carbamazepine-induced Stevens–Johnson syndrome and toxic epidermal necrolysis in an Indian population: a pooled-data analysis and meta-analysis. Epilepsia 55(11), e120–e124 (2014).
- 16. Association of HLA-B*15:02 allele and carbamazepine-induced Stevens–Johnson syndrome among Indians. Indian Journal of Dermatology, Venereology and Leprology 75, 579 (2009).
- 17. HLA-B*15:02 association with carbamazepine-induced Stevens–Johnson syndrome and toxic epidermal necrolysis in an Indian population: a pooled-data analysis and meta-analysis. Epilepsia 55(11), e120–e124 (2014).
- 18. A study of HLA-B*15:02 in 9 different Chinese ethnics: implications for carbamazepine related SJS/TEN. HLA 89(4), 225–229 (2017).
- 19. rs144012689 is a highly specific representative marker of HLA-B*15:02 in the Chinese population. Pharmacogenomics 23(15), 835–845 (2022).
- 20. HLA class I (A, B, C) and class II (DRB1, DQA1, DQB1, DPB1) alleles and haplotypes in the Han from southern China. Tissue Antigens 70(6), 455–463 (2007).
- 21. Distributions of HLA class I alleles and haplotypes in northern Han Chinese. Tissue Antigens 66(4), 297–304 (2005).
- 22. HLA-B allele and haplotype diversity among Thai patients identified by PCR-SSOP: evidence for high risk of drug-induced hypersensitivity. Front. Genet. 5, 478 (2014).
- 23. Usage pattern of carbamazepine and associated severe cutaneous adverse reactions in singapore following implementation of HLA-B*15:02 genotyping as standard-of-care. Front Pharmacol. 11, 527 (2020).
- 24. . Association of HLA-B*15:02 allele with carbamazepine-induced toxic epidermal necrolysis and Stevens–Johnson syndrome in the multi-ethnic Malaysian population. Int. J. Dermatol. 50(2), 221–224 (2011).
- 25. . Should we identify HLA-B*15:02 polymorphism before prescribing carbamazepine to Indonesian patients? A study among febrile seizure patients with a high risk of epilepsy. Drug Invention Today 11(3), 531–538 (2019).
- 26. Polymorphisms of HLA genes in western Javanese (Indonesia): close affinities to southeast Asian populations. Tissue Antigens 73(1), 46–53 (2009).
- 27. . The pharmacogenomics of carbamazepine-induced cutaneous adverse drug reaction in the South of Vietnam. Front. Pharmacol. 14, 1217516 (2023).
- 28. HLA-B*15:02 and carbamazepine-induced severe cutaneous adverse drug reactions in Vietnamese. Asia Pacific Allergy 5(2), 68–77 (2015).
- 29. . Genetics of immune-mediated adverse drug reactions: a comprehensive and clinical review. Clin. Rev. Allergy Immunol. 48(2–3), 165–175 (2015).
- 30. HLA-B locus in Japanese patients with anti-epileptics and allopurinol-related Stevens–Johnson syndrome and toxic epidermal necrolysis. Pharmacogenomics 9(11), 1617–1622 (2008).
- 31. Recommendations for HLA-B*15:02 and HLA-A*31:01 genetic testing to reduce the risk of carbamazepine-induced hypersensitivity reactions. Epilepsia 55(4), 496–506 (2014).
- 32. Repurposing HLA genotype data of renal transplant patients to prevent severe drug hypersensitivity reactions. Front. Genet. 14, 1289015 (2023).
- 33. . Carbamazepine therapy and HLA genotype. In: Medical Genetics Summaries. Pratt VScott SPirmohamed MEsquivel BKattman BMalheiro A (Eds). National Center for Biotechnology Information, MD, USA, 137–154 (2012).
- 34. HLA alleles and antiseizure medication-induced cutaneous reactions in Brazil: a case–control study. HLA 102(3), 269–277 (2023).
- 35. . HLA typing by SSO and SSP methods. Methods Mol. Biol. 882, 9–25 (2012).
- 36. A nested sequence-specific primer-polymerase chain reaction for the detection of HLA-B*15:02. Tissue Antigens 79(4), 295–301 (2012).
- 37. Implementation of HLA-B*15:02 genotyping as standard-of-care for reducing carbamazepine/oxcarbazepine induced cutaneous adverse drug reactions in Thailand. Front. Pharmacol. 13, 867490 (2022).
- 38. Spectrum of cutaneous adverse reactions to aromatic antiepileptic drugs and human leukocyte antigen genotypes in Thai patients and meta-analysis. Pharmacogenomics J. 21(6), 682–690 (2021).
- 39. HLA-B27 genotyping by fluorescent resonance emission transfer (FRET) probes in real-time PCR. Hum. Immunol. 65(8), 826–838 (2004).
- 40. Real-time PCR based HLA-B*27 screening directly in whole blood. HLA 95(3), 189–195 (2020).
- 41. A novel multiplex polymerase chain reaction assay for detection of both HLA-A*31:01/HLA-B*15:02 alleles, which confer susceptibility to carbamazepine-induced severe cutaneous adverse reactions. HLA 90(6), 335–342 (2017).
- 42. Development of a rapid and reliable single-tube multiplex real-time PCR method for HLA-A*24:02 genotyping. Pharmacogenomics 20(11), 803–812 (2019).
- 43. . Validation of single nucleotide variant assays for human leukocyte antigen haplotypes HLA-B*15:02 and HLA-A*31:01 across diverse ancestral backgrounds. Frontiers in Pharmacology 12, 713178 (2021).
- 44. rs144012689 is a highly specific representative marker of HLA-B*15:02 in the Chinese population. Pharmacogenomics 23(15), 835–845 (2022).
- 45. . High-throughput two-dimensional polymerase chain reaction technology. Anal. Chem. 92(1), 674–682 (2019).
- 46. The mechanism and regularity of quenching the effect of bases on fluorophores: the base-quenched probe method. Analyst 143(14), 3292–3301 (2018).
- 47. Accurate identification of HLA-B*15:02 allele by two-dimensional polymerase chain reaction. Clin. Chim. Acta 552, 117654 (2023).
- 48. . The HLA-B*15:02:01:05 allele identified by two next-generation sequencing methods in a Japanese individual. HLA 100(5), 522–523 (2022).
- 49. Novel alleles in the era of next-generation sequencing-based HLA typing calls for standardization and policy. Front. Genet. 14, 1282834 (2023).
- 50. . A clinician's guide to bioinformatics for next-generation sequencing. J. Thorac. Oncol. 18(2), 143–157 (2023).
- 51. . A national proficiency scheme for human leucocyte antigen typing by next-generation sequencing. Clin. Chim. Acta 533, 85–88 (2022).
- 52. Validation and application of new NGS-based HLA genotyping to clinical diagnostic practice. HLA 101(5), 496–506 (2023).
- 53. Next-generation sequencing technology: current trends and advancements. Biology 12(7), 997 (2023).
- 54. Identification of a single nucleotide deletion in the novel HLA-DQB1*06:379N allele, detected by polymerase chain reaction-sequence based typing but not by next generation sequencing. HLA 96(6), 709–713 (2020).
- 55. Super high-resolution single-molecule sequence-based typing of HLA class I alleles in HIV-1 infected individuals in Ghana. PLOS ONE 17(6), e0269390 (2022).
- 56. . New challenges, new opportunities: next generation sequencing and its place in the advancement of HLA typing. Hum. Immunol. 82(7), 478–487 (2021).
- 57. Ambiguous allele combinations in HLA class I and class II sequence-based typing: when precise nucleotide sequencing leads to imprecise allele identification. J. Transl. Med. 2(1), 30 (2004).
- 58. High-throughput simultaneous genotyping of human platelet antigen-1 to 16 by using suspension array. Transfusion 53(11), 2722–2728 (2013).
- 59. Development of a high-resolution mass-spectrometry-based method and software for human leukocyte antigen typing. Front. Immunol. 14, 1188381 (2023).
- 60. . Adverse effects of antiepileptic drugs. Lancet Neurol. 11(9), 792–802 (2012).
- 61. . The role of HLA genes in pharmacogenomics: unravelling HLA associated adverse drug reactions. Immunogenetics 69(8–9), 617–630 (2017).
- 62. Reactive metabolites of the anticonvulsant drugs and approaches to minimize the adverse drug reaction. Eur. J. Med. Chem. 226, 113890 (2021).
- 63. . Clinical heterogeneity of drug hypersensitivity. Toxicology 209(2), 123–129 (2005).
- 64. . The spectrum of Stevens–Johnson syndrome and toxic epidermal necrolysis: a clinical classification. J. Invest. Dermatol. 102(6), S28–S30 (1994).
- 65. . Stevens–Johnson syndrome and toxic epidermal necrolysis: Pathogenesis, clinical manifestations, and diagnosis. UpToDate. UpToDate Inc., MA, USA (2020). www.uptodate.com
- 66. Common risk allele in aromatic antiepileptic-drug induced Stevens–Johnson syndrome and toxic epidermal necrolysis in Han Chinese. Pharmacogenomics 11(3), 349–356 (2010).
- 67. Association between HLA and Stevens–Johnson syndrome induced by carbamazepine in southern Han Chinese: genetic markers besides B*15:02? Basic Clin. Pharmacol. Toxicol. 111(1), 58–64 (2012).
- 68. Association between HLA-B*15:02 allele and carbamazepine-induced severe cutaneous adverse reactions in Han people of southern China mainland. Seizure 20(6), 446–448 (2011).
- 69. Strong association between HLA-B*15:02 and carbamazepine-induced Stevens–Johnson syndrome and toxic epidermal necrolysis in mainland Han Chinese patients. Eur. J. Clin. Pharmacol. 67(9), 885–887 (2011).
- 70. . The association between HLA-B*15:02 and phenytoin-induced severe cutaneous adverse reactions: a meta-analysis. Pharmacogenomics 23(1), 49–59 (2021).
- 71. . The association of HLA-B*15:02 allele and Stevens–Johnson syndrome/toxic epidermal necrolysis induced by aromatic anticonvulsant drugs in a South Indian population. Int. J. Dermatol. 57(1), 70–73 (2018).
- 72. HLA-B*15:02 is associated with carbamazepine induced Stevens–Johnson syndrome in North Indian population. Hum. Immunol. 75(11), 1120–1122 (2014).
- 73. Association of HLA-B*15:13 and HLA-B*15:02 with phenytoin-induced severe cutaneous adverse reactions in a Malay population. Pharmacogenomics J. 17(2), 170–173 (2017).
- 74. . Association of HLA-B*15:02 allele with carbamazepine-induced toxic epidermal necrolysis and Stevens–Johnson syndrome in the multi-ethnic Malaysian population. Int. J. Dermatol. 50(2), 221–224 (2011).
- 75. Association of the HLA-B alleles with carbamazepine-induced Stevens–Johnson syndrome/toxic epidermal necrolysis in the Javanese and Sundanese population of Indonesia: the important role of the HLA-B75 serotype. Pharmacogenomics 18(18), 1643–1648 (2017).
- 76. Genetic susceptibilities and prediction modeling of carbamazepine and allopurinol-induced severe cutaneous adverse reactions in Vietnamese. Pharmacogenomics 22(1), 1–12 (2021).
- 77. Association of carbamazepine-induced severe cutaneous drug reactions and HLA-B*15:02 allele status, and dose and treatment duration in paediatric neurology patients in Singapore. Arch. Dis. Child 99(6), 581–584 (2014).
- 78. Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans. Epilepsy Res. 97(1–2), 190–197 (2011).
- 79. Recommendations for HLA-B*15:02 and HLA-A*31:01 genetic testing to reduce the risk of carbamazepine-induced hypersensitivity reactions. Epilepsia 55(4), 496–506 (2014).
- 80. HLA-A31 strongly associates with carbamazepine-induced adverse drug reactions but not with carbamazepine-induced lymphocyte proliferation in a Japanese population. J. Dermatol. 39(7), 594–601 (2012).
- 81. HLA-B locus in Caucasian patients with carbamazepine hypersensitivity. Pharmacogenomics 7(6), 813–818 (2006).
- 82. A European study of HLA-B in Stevens–Johnson syndrome and toxic epidermal necrolysis related to five high-risk drugs. Pharmacogenet. Genomics 18(2), 99–107 (2008).
- 83. Significant HLA class I type associations with aromatic antiepileptic drug (AED)-induced SJS/TEN are different from those found for the same AED-induced DRESS in the Spanish population. Pharmacol. Res. 115, 168–178 (2017).
- 84. . Updates and insights in the diagnosis and management of DRESS syndrome. Curr. Dermatol. Rep. 10(4), 192–204 (2021).
- 85. Genetic susceptibility to carbamazepine-induced cutaneous adverse drug reactions. Pharmacogenet. Genomics 16(4), 297–306 (2006).
- 86. HLA alleles and CYP2C9*3 as predictors of phenytoin hypersensitivity in East Asians. Clin. Pharmacol. Ther. 105(2), 476–485 (2019).
- 87. HLA-A*02:01:01/-B*35:01:01/-C*04:01:01 haplotype associated with lamotrigine-induced maculopapular exanthema in Mexican Mestizo patients. Pharmacogenomics 15(15), 1881–1891 (2014).
- 88. HLA-A*31:01 and different types of carbamazepine-induced severe cutaneous adverse reactions: an international study and meta-analysis. Pharmacogenomics J. 14(3), 281–288 (2014).
- 89. Association between HLA-B alleles and carbamazepine-induced maculopapular exanthema and severe cutaneous reactions in Thai patients. J. Immunol. Res. 2018, 2780272 (2018).
- 90. . The association between HLA-B*15:02 and phenytoin-induced severe cutaneous adverse reactions: a meta-analysis. Pharmacogenomics 23(1), 49–59 (2022).
- 91. HLA-A*31:01 and different types of carbamazepine-induced severe cutaneous adverse reactions: an international study and meta-analysis. Pharmacogenomics J. 14(3), 281–288 (2014).
- 92. Carbamazepine-induced severe cutaneous adverse reactions and HLA genotypes in Koreans. Epilepsy Res. 97(1–2), 190–197 (2011).
- 93. Genome-wide association study identifies HLA-A*31:01 allele as a genetic risk factor for carbamazepine-induced cutaneous adverse drug reactions in Japanese population. Hum. Mol. Genet 20(5), 1034–1041 (2011).
- 94. HLA-A*31:01 and carbamazepine-induced hypersensitivity reactions in Europeans. N. Engl. J. Med. 364(12), 1134–1143 (2011).
- 95. HLA-A*31:01 and HLA-B*15:02 as genetic markers for carbamazepine hypersensitivity in children. Clin. Pharmacol. Ther. 94(1), 142–149 (2013).
- 96. Severe Delayed Cutaneous and Systemic Reactions to Drugs: A Global Perspective on the Science and Art of Current Practice. J. Allergy Clin. Immunol. Pract. 5(3), 547–563 (2017).
- 97. An updated review of the diagnostic methods in delayed drug hypersensitivity. Front. Pharmacol. 11, 573573 (2020).
- 98. Comparison and predictors of rash associated with 15 antiepileptic drugs. Neurology 68(20), 1701–1709 (2007).
- 99. HLA-B*40:02 and DRB1*04:03 are risk factors for oxcarbazepine-induced maculopapular eruption. Epilepsia 57(11), 1879–1886 (2016).
- 100. Association of HLA genotypes with phenobarbital hypersensitivity in children. Epilepsia 57(10), 1610–1616 (2016).
- 101. Association between human leukocyte antigens and cutaneous adverse drug reactions to antiepileptics and antibiotics in the Iranian population. Dermatologic. Therapy 35(5), e15393 (2022).
- 102. The association between HLA-A*03:01 and HLA-B*07:02 alleles and oxcarbazepine-induced maculopapular eruption in the Uighur Chinese population. Seizure 81, 43–46 (2020).
- 103. HLA risk alleles in aromatic antiepileptic drug-induced maculopapular exanthema. Front. Pharmacol. 12, 671572 (2021).
- 104. Do HLA-A markers predict skin-reactions from aromatic antiepileptic drugs in a Norwegian population? A case control study. Epilepsy Res. 118, 5–9 (2015).
- 105. Pilot association study of oxcarbazepine-induced mild cutaneous adverse reactions with HLA-B*15:02 allele in Chinese Han population. Seizure 20(2), 160–162 (2011).
- 106. Association between the HLA-B*15:02 gene and mild maculopapular exanthema induced by antiepileptic drugs in Northwest China. BMC Neurol. 21(1), 340 (2021).
- 107. Cutaneous reactions induced by oxcarbazepine in Southern Han Chinese: incidence, features, risk factors and relation to HLA-B alleles. Seizure 21(8), 614–618 (2012).
- 108. The association between oxcarbazepine-induced maculopapular eruption and HLA-B alleles in a northern Han Chinese population. BMC Neurol. 13, 75 (2013).
- 109. Association between HLA-B*15:02 and carbamazepine-induced severe cutaneous adverse drug reactions in a Thai population. Epilepsia 51(5), 926–930 (2010).
- 110. Predictive markers for carbamazepine and lamotrigine-induced maculopapular exanthema in Han Chinese. Epilepsy Res. 106(1–2), 296–300 (2013).
- 111. HLA-A*24:02 as a common risk factor for antiepileptic drug-induced cutaneous adverse reactions. Neurology 88(23), 2183–2191 (2017).
- 112. HLA-targeted sequencing reveals the pathogenic role of HLA-B*15:02/HLA-B*13:01 in albendazole-induced liver failure: a case report and a review of the literature. Front. Pharmacol. 14, 1288068 (2023).
- 113. . Human leukocyte antigen (HLA) and immune regulation: how do classical and non-classical HLA alleles modulate immune response to human immunodeficiency virus and hepatitis C virus infections? Front. Immunol. 8, 832 (2017).
- 114. . Sulfamethoxazole induces a switch mechanism in T cell receptors containing TCRVbeta20-1, altering pHLA recognition. PLOS ONE 8(10), e76211 (2013).
- 115. . A recent update of pharmacogenomics in drug-induced severe skin reactions. Drug Metab. Pharmacokinet. 27(1), 132–141 (2012).
- 116. Effects of ABCB1, HLA-B*15:02 and EPHX1 genetic polymorphisms on carbamazepine pharmacokinetics in healthy subjects [in Chinese]. Chinese J. Clin. Pharmacol. 38(9), 979–983 (2022).
- 117. Defective regulatory T cells in patients with severe drug eruptions: timing of the dysfunction is associated with the pathological phenotype and outcome. J. Immunol. 182(12), 8071–8079 (2009).
- 118. . Severe cutaneous adverse drug reactions. J. Dermatol. 43(7), 758–766 (2016).
- 119. Targeted therapy guided by single-cell transcriptomic analysis in drug-induced hypersensitivity syndrome: a case report. Nat. Med. 26(2), 236–243 (2020).
- 120. Cost-effectiveness analysis of genotyping for HLA-B*15:02 in Indonesian patients with epilepsy using a generic model. Pharmacogenomics J. 21(4), 476–483 (2021).
- 121. . Real-world efficiency of pharmacogenetic screening for carbamazepine-induced severe cutaneous adverse reactions. PLOS ONE 9(5), e96990 (2014).
- 122. . Cost-effectiveness of screening for HLA-B*15:02 prior to initiation of carbamazepine in epilepsy patients of Asian ancestry in the United States. Epilepsia 60(7), 1472–1481 (2019).
- 123. Integrating real-world data in cost-effectiveness analysis of universal HLA-B*15:02 screening in Malaysia. Br. J. Clin. Pharmacol. 89(11), 3340–3351 (2023).
- 124. Clinical pharmacogenetics implementation consortium guideline for hla genotype and use of carbamazepine and oxcarbazepine: 2017 update. Clin. Pharmacol. Ther. 103(4), 574–581 (2018).
- 125. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2C9 and HLA-B genotypes and phenytoin dosing: 2020 update. Clin. Pharmacol. Ther. 109(2), 302–309 (2021).
- 126. . Effects of a HLA-B*15:02 screening policy on antiepileptic drug use and severe skin reactions. Neurology 83(22), 2077–2084 (2014).
- 127. Implementation of HLA-B*15:02 genotyping as standard-of-care for reducing carbamazepine/oxcarbazepine induced cutaneous adverse drug reactions in Thailand. Front Pharmacol. 13, 867490 (2022).
- 128. . Risk of serious cutaneous disorders after initiation of use of phenytoin, carbamazepine, or sodium valproate: a record linkage study. Neurology 49(2), 542–546 (1997).
- 129. Medication use and the risk of Stevens–Johnson syndrome or toxic epidermal necrolysis. N. Engl. J. Med. 333(24), 1600–1607 (1995).
- 130. ALDEN, an algorithm for assessment of drug causality in Stevens–Johnson Syndrome and toxic epidermal necrolysis: comparison with case-control analysis. Clin. Pharmacol. Ther. 88(1), 60–68 (2010).
- 131. . Question 2: Would systemic steroids be useful in the management of Stevens–Johnson syndrome? Arch. Dis. Child 98(10), 828–830 (2013).
- 132. Clinical features, outcomes and treatment in children with drug induced Stevens–Johnson syndrome and toxic epidermal necrolysis. Acta Biomed. 90(3S), 52–60 (2019).
- 133. . Toxic epidermal necrolysis: Part II. Prognosis, sequelae, diagnosis, differential diagnosis, prevention, and treatment. J. Am. Acad Dermatol. 69(2), 187; e181–116; quiz 203–184 (2013).
- 134. Clinical features of Stevens–Johnson syndrome and toxic epidermal necrolysis. Pediatr. Int. 60(8), 697–702 (2018).
- 135. . Intravenous immunoglobulin does not improve outcome in toxic epidermal necrolysis. J. Burn Care Rehabil. 25(3), 246–255 (2004).
- 136. Evaluation of combination therapy with etanercept and systemic corticosteroids for Stevens–Johnson syndrome and toxic epidermal necrolysis: a multicenter observational study. J. Allergy Clin. Immunol. Pract. 10(5), 1295–1304; e1296 (2022).
- 137. . Drug reaction with eosinophilia and systemic symptoms (DRESS): incidence, pathogenesis and management. Expert Opin. Drug Saf. 16(2), 139–147 (2017).
- 138. . Evaluation of cyclosporine for the treatment of DRESS syndrome. JAMA Dermatol. 156(6), 704–706 (2020).
- 139. Drug-induced hypersensitivity syndrome with myocardial involvement treated with tofacitinib. JAAD Case Rep. 5(12), 1018–1026 (2019).