Q: Should you test Asian patients for HLA-B*1502 before presecribing AEDs?

I think this is a fascinating question. In paediatric oncology, we’re been doing a tiny bit of genetically personalised medicine for a while now, testing the allelic variations of thiopurine metabolisers so we don’t (over~) poison a small proportion of children with ALL. There are suggestions that similar issues might be around for folk who develop aminoglycoside deafness, or even severe post-chemo vomiting.

But when the question “Should Phenytoin and Carbamazepine be Avoided in Asian Population with HLA-B*1502 Positive Genetic Variant?” was raised from Leicester, I was delighted to see that non-Oncologists were doing the same sort of questioning.

So do you test, or not?

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