Role of HLA-B*5801 genotyping prior to initiation of allopurinol

MOH and HSA would like to inform healthcare professionals that routine genotyping for the HLA-B*5801 allele prior to the initiation of allopurinol therapy is not required as standard of care in the local context. The basis for this recommendation took into consideration the low Positive Predictive Value (PPV) of 2.4% of HLA-B*5801 for allopurinol-induced Serious Cutaneous Adverse Reactions (SCAR), limited alternative urate-lowering therapies (ULTs), and the unfavourable cost-effectiveness analysis based on current data. Genotyping may be considered in patients who have other pre-existing risk factors such as renal impairment to identify patients at high risk of allopurinol-induced SCAR. Healthcare professionals are advised to use allopurinol with caution. Genetic testing should not substitute for appropriate clinical vigilance and patient management.

 
 
Healthcare professional, Therapeutic Products
Published:

Dear Healthcare Professional Letters

12 Dec 2019

Only abstracts of the Dear Healthcare Professional Letters (DHCPL) are provided on this website. Details of the letters can be found on the MOH Alert System, which is accessible via the Health Professionals Portal (HPP). HPP is a one-stop portal for all healthcare professionals in Singapore. Dentists, medical doctors and pharmacists may access HPP at https://www.moh.gov.sg/hpp/, and follow the procedures below to access the MOH Alert system.

Step 1: On the top navigation ribbon of webpage, select 'For Healthcare Professionals' followed by 'Health Professionals Portal' and click on the choice of profession. User will be redirected to the specific HPP webpage for the selected profession.

Step 2: Click on the Restricted Content icon on the left panel of webpage and login via SingPass.

Step 3: Click on the MOH Alert icon under ‘Applications’ section

Step 4: Click on the Drug Alert tab to view the DHCPLs.