The genotype here is checked before the first dose and never again, and what it predicts is not how well the drug works but whether it is safe to start. It is also the clearest case on this site of a test that only makes sense for some populations.
The HLA-B*58:01 allele is associated with a substantially increased risk of severe cutaneous adverse reactions to allopurinol — Stevens–Johnson syndrome, toxic epidermal necrolysis and DRESS. CPIC published a guideline for HLA-B genotype and allopurinol dosing and confirmed in its 2015 update that the original recommendation stands. Allele frequency varies widely between populations, which is why testing guidance is population-specific rather than universal. This is a safety check before prescribing, not a dosing adjustment and not something to act on from a raw data file.
CPIC guidelines for HLA-B genotype and allopurinol dosing: 2015 update (Clin Pharmacol Ther 2016, PMID 26094938).
These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.
HLA-B · rs114985235
Read more →HLA-B · rs2523590
Read more →HLA-B · rs2395029
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