ArticleJAMA dermatology2019
Evaluation of Prospective HLA-B*13:01 Screening to Prevent Dapsone Hypersensitivity Syndrome in Patients With Leprosy.
Article in JAMA dermatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- Genetic testing for prevention of severe drug-induced skin rash.The Cochrane database of systematic reviews · 2019Pooled it
- RIMOXCLAMIN's Therapeutic Impact in a Larger Brazilian Hansen's Disease Population.Open forum infectious diseases · 2026Trial
- Predictive Safety in the Era of Artificial Intelligence: Promises, Limits, and the Case for an Enterprise Lifecycle Evidence Ecosystem.Drug safety · 2026Review
- Article
- Outcomes of alternative therapy in HLA-B* 13:01 positive leprosy patients without dapsone versus standard MDT in negative patients: A comparative effectiveness study.PLoS neglected tropical diseases · 2026Article
- Human leukocyte antigen pharmacogenetics in infectious diseases: anti-infective drug toxicity and host immune response.Frontiers in pharmacology · 2026Review
- HLA-B Alleles With Shared Peptide Binding Specificities Define Global Risk of Co-trimoxazole-Induced Severe Cutaneous Adverse Drug Reactions.The journal of allergy and clinical immunology. In practice · 2025Article
- Alpha-Lipoic Acid Reduces Methemoglobin and Oxidative Imbalance in the Blood and Liver Induced by Dapsone in Mice: Molecular Mechanism of Antioxidant Action.ACS pharmacology & translational science · 2025Article
- TSC22 domain family member 3 links natural killer cells to CD8+ T cell-mediated drug hypersensitivity.Signal transduction and targeted therapy · 2025Article
- Feedback regulation of VISTA and Treg by TNF-α controls T cell responses in drug allergy.Allergy · 2025Article
- Challenges associated with dapsone for leprosy treatment in Indonesia - urgent need for access to alternative antimicrobial drugs.The Lancet regional health. Southeast Asia · 2025Review
- Dapsone as a Current Option for the Treatment of Autoimmune Bullous Diseases with Autoimmunity to Non-Enzymes: A Retrospective Study from a Single Central European Referral Center.Medicina (Kaunas, Lithuania) · 2024Article
- Knowledge mapping and global trends of drug hypersensitivity from 2013 to 2023: A bibliometric analysis.Immunity, inflammation and disease · 2024Article
- Review
- Adverse reactions induced by MDT/WHO (Rifampicin+Clofazimine+Dapsone) and ROM (Rifampicin+Ofloxacin+Minocycline) regimens used in the treatment of leprosy: a cohort study in a National Reference Center in Brazil.Frontiers in pharmacology · 2024Article
- Overview and Current Advances in Dapsone Hypersensitivity Syndrome.Current allergy and asthma reports · 2023Review
- Tools for Etiologic Diagnosis of Drug-Induced Allergic Conditions.International journal of molecular sciences · 2023Review
- [Genetic susceptibility to drug-induced liver injury].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2023Article
- Activation of Human CD8+ T Cells with Nitroso Dapsone-Modified HLA-B*13:01-Binding Peptides.Journal of immunology (Baltimore, Md. : 1950) · 2023Article
- Updates in SJS/TEN: collaboration, innovation, and community.Frontiers in medicine · 2023Review
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Authors and funding
70 authors at 17 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Dapsone hypersensitivity syndrome (DHS) is the most serious adverse reaction associated with dapsone administration and one of the major causes of death in patients with leprosy, whose standard treatment includes multidrug therapy (MDT) with dapsone, rifampicin, and clofazimine. Although the HLA-B*13:01 polymorphism has been identified as the genetic determinant of DHS in the Chinese population, no studies to date have been done to evaluate whether prospective HLA-B*13:01 screening could prevent DHS by identifying patients who should not receive dapsone. Objective: To evaluate the clinical use of prospective HLA-B*13:01 screening for reduction of the incidence of DHS by excluding dapsone from the treatment for patients with HLA-B*13:01-positive leprosy. Design, Setting, and Participants: A prospective cohort study was conducted from February 15, 2015, to April 30, 2018, in 21 provinces throughout China. A total of 1539 patients with newly diagnosed leprosy were enrolled who had not received dapsone previously. After excluding patients who had a history of allergy to sulfones or glucose-6-phosphate dehydrogenase deficiency, 1512 individuals underwent HLA-B*13:01 genotyping. All of the patients were followed up weekly for the first 8 weeks after treatment to monitor for adverse events. Exposures: Patients who were HLA-B*13:01 carriers were instructed to eliminate dapsone from their treatment regimens, and noncarrier patients received standard MDT. Main Outcomes and Measures: The primary outcome was the incidence of DHS. The historical incidence rate of DHS (1.0%) was used as a control. Results: Among 1512 patients (1026 [67.9%] men, 486 [32.1%] women; mean [SD] age, 43.1 [16.2] years), 261 (17.3%) were identified as carriers of the HLA-B*13:01 allele. A total of 714 adverse events in 384 patients were observed during the follow-up period. Dapsone hypersensitivity syndrome did not develop in any of the 1251 patients who were HLA-B*13:01-negative who received dapsone, while approximately 13 patients would be expected to experience DHS, based on the historical incidence rate of 1.0% per year (P = 2.05 × 10-5). No significant correlation was found between other adverse events, including dermatologic or other events, and HLA-B*13:01 status. Conclusions and Relevance: Prospective HLA-B*13:01 screening and subsequent elimination of dapsone from MDT for patients with HLA-B*13:01-positive leprosy may significantly reduce the incidence of DHS in the Chinese population.
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