TY - JOUR T1 - Febuxostat Desensitization in a Patient with Previous Stevens-Johnson Syndrome and <em>HLA-B*58:01</em> Genotype JF - The Journal of Rheumatology JO - J Rheumatol SP - 1250 LP - 1251 DO - 10.3899/jrheum.181051 VL - 46 IS - 9 AU - TENNEILLE TANA AU - PETER VADAS Y1 - 2019/09/01 UR - http://www.jrheum.org/content/46/9/1250.abstract N2 - To the Editor:We describe the first case, to our knowledge, of successful desensitization to febuxostat in a young high-risk patient of Filipino descent with HLA-B*58:01 positive genotype and previous drug-induced Stevens-Johnson Syndrome (SJS), with 2 subsequent episodes of a morbilliform rash with repeat exposures to febuxostat.Drug-induced severe cutaneous adverse reactions (SCAR) include a wide variety of different cutaneous manifestations including SJS, toxic epidermal necrolysis (TEN), drug-induced hypersensitivity syndrome, and drug reaction with eosinophilia and systemic signs (DRESS). Allopurinol, anticonvulsants, and antibiotics are among the most common causes, with allopurinol being the most common trigger. The mortality rate for allopurinol-induced SCAR is as high as 25% in certain genotypes and ethnicities1. The HLA-B*58:01 risk allele is strongly associated with SCAR, with variable prevalence rates in specific ethnicities; most notably in the Asian population1. However, in a metaanalysis of 9 population-control studies, HLA-B*58:01 for detecting allopurinol-induced TEN/SJS was found to be universal in Chinese, Japanese, and white populations2.The 2015 Clinical Pharmacogenetics Implementation Consortium guidelines … Address correspondence to Dr. T. Tana, St. Michael’s Hospital, Division of Allergy and Clinical Immunology, 30 Bond St., Room 8-161, Cardinal Carter Wing, Toronto, Ontario M5B 1W8, Canada. E-mail: t.loo{at}mail.utoronto.ca ER -