Pharmacogenomics of lamotrigine: a possible link to serious cutaneous adverse reactions

Abstract Introduction: Lamotrigine's packaging contains a boxed warning for serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis. The purpose of this review is to summarize literature pertaining to HLA genetic polymorphisms that may increase susceptibility to serious skin reactions induced by lamotrigine. Methods: A literature search of PubMed/MEDLINE and Ovid IPA was conducted using the following search terms: lamotrigine, genetic polymorphism, pharmacogenetics, pharmacogenomics, predictive genetic testing, anticonvulsants, hypersensitivity, and HLA-B. Results: Three case-control studies were identified focusing on genetic polymorphisms that can cause direct susceptibility to serious skin reactions, such as HLA-B*1502. Other factors were also taken into consideration, such as age, concomitant medications, ethnicity, and smoking status. Most results were not statistically significant but rather hypothesis generating and were limited by small sample size and study desig...