Gout and the Game-Changing Test
Gout is a painful condition caused by the buildup of uric acid in the joints. Doctors often prescribe allopurinol to manage it, but this medication can lead to severe skin reactions in some individuals.
A New Gene Discovery
Recently, scientists identified a new gene, HLA-A*34:02, which, when combined with another gene, HLA-B*58:01, can help predict who might face these dangerous side effects.
Why This Matters
- The previous gene test only focused on HLA-B*58:01 and missed many at-risk patients, particularly those who are Black.
- The new gene test covers over 80% of severe skin reactions in U.S. patients taking allopurinol, offering a more comprehensive approach.
The Risk of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis
Allopurinol can trigger a rare but life-threatening skin condition called Stevens-Johnson syndrome/toxic epidermal necrolysis. This condition causes:
- Painful rashes
- Blisters
- Peeling skin
Often requiring hospitalization, up to 30% of people who develop this from allopurinol do not survive.
Current Screening Practices
Currently, doctors only test for the HLA-B*58:01 gene in Asian and Black patients before prescribing allopurinol. However, this new gene test could mean that more people need to be screened before starting the medication.
Limitations and Future Research
Despite this breakthrough, there are still limitations:
- Not everyone at risk will be identified by these tests.
- Doctors must carefully discuss the risks with their patients.
In the future, researchers aim to develop even better tests that can accurately identify all patients at risk for severe drug reactions, regardless of their background.
