Genetic Link Between HLA-A*32:01 and Lamotrigine-Related DRESS: Insights for Clinical Practice
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By
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Kun Lin Lu
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September 2, 2026
Clinical Report: Genetic Link Between HLA-A*32:01 and Lamotrigine-Related DRESS
Overview
A matched case-control study found a significant association between HLA-A*32:01 and lamotrigine-induced DRESS, with 41.4% of cases carrying the allele compared to 4.1% of controls. The odds ratio for developing DRESS in HLA-A*32:01 carriers was 16.4.
Background
The identification of genetic risk factors for severe cutaneous adverse reactions (SCARs) has advanced pharmacogenomics significantly. Lamotrigine, a common treatment for bipolar disorder and epilepsy, is associated with DRESS, a severe hypersensitivity reaction that can lead to high morbidity and mortality. Understanding the genetic predisposition to such reactions is crucial for improving patient safety.
Data Highlights
| Group | HLA-A*32:01 Carriage |
|---|---|
| DRESS Cases (n=29) | 41.4% |
| Lamotrigine-Tolerant Controls (n=290) | 4.1% |
Key Findings
- HLA-A*32:01 was found in 41.4% of DRESS cases versus 4.1% in controls (OR 16.4; 95% CI, 6.4-42.5).
- 69.0% of DRESS cases exhibited concurrent acute liver injury.
- HLA-A*32:01 screening is not currently included in commercial SCAR prevention panels.
- The allele accounted for only 41.4% of observed DRESS cases, indicating other factors may contribute.
Clinical Implications
Clinicians should be aware of the association between HLA-A*32:01 and lamotrigine-induced DRESS when prescribing this medication.
Conclusion
The findings link HLA-A*32:01 with lamotrigine-induced DRESS.
Related Resources & Content
- Krantz, M. et al., JAMA Network Open, 2026 -- Association of HLA-A*32:01 with Lamotrigine-Related Drug Reaction Featuring Eosinophilia and Systemic Symptoms
- Andrade, R. J. et al., Archives of Toxicology, 2023 -- Analysis of Drug-Induced Liver Injury Linked to Drug Reaction with Eosinophilia and Systemic Symptoms in Two DILI Prospective Registries
- Frontiers in Pediatrics, 2026 -- Clinical implications of HLA-B*15:02 screening in pediatric patients: A case series from a Thai Binh Children's Hospital, Vietnam
- Clinical Rheumatology — Bioinformatics Integration and Clinical Validation Identify PRDX6 as a Key Mitochondrial Gene in Systemic Lupus Erythematosus
- JAMA Network Open Article
- DailyMed - LAMICTAL Prescribing Information
- Severe Cutaneous Adverse Reactions Associated With Newer‐Generation Antiseizure Medications: A Real‐World Pharmacovigilance Study Based on FAERS and JADER - PMC
Based on findings from:
HLA-A*32:01 and Lamotrigine-Induced DRESS—From Genetic Association to Clinical Implementation
Kun Lin Lu. Jama Network Open, 2026.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2853520
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