Topic Status Complete
Pharmacogenetic testing to identify the risk of adverse reactions to anti-epileptic medications.
The evidence on the use of pharmacogenetics testing to identify the risk of adverse reactions to anti-epileptic medications is limited.
Some evidence was identified on the use of human leukocyte antigen (HLA) testing to determine whether carbamazepine treatment should be prescribed. However, expert opinion suggests that carbamazepine is highly unlikely to be prescribed to people with newly diagnosed epilepsy as they are likely to be offered a drug with a lower rate of adverse drug reactions instead. As such, using the test to decide whether to prescribe carbamazepine may be of limited applicability to current practice.
The HTW Assessment Group concluded that informed guidance could not be made at this time.
Why was this topic appraised?
Some antiepileptic medications can induce serious hypersensitivity reactions. These reactions are rare, but severe. Genetic markers have been associated with these adverse reactions, in particular HLA alleles. Using genetic testing for these markers before starting treatment could identify people who are most at risk of a reaction and may benefit from an alternative treatment choice.