Association of HLA Alleles with Anti-Epileptic (Carbamazepine and Phenytoin) in Inducing Steven Johnson Syndrome or Toxic Epidermal Necrolysis: A Narrative Review

ASM Sc. J., 21(1), 2026

Published on February 26, 2026

https://doi.org/10.32802/asmscj.2026.1632

Author: Nurul Nadia Feizal, Nurriansyuhadah Jasril, Adriana Syuhada Ahmad Najmi, Siti Nor Azizah Ab Halim, Mohd Ikhwan Ismail, Fazleen Haslinda Mohd Hatta

Abstract

Adverse drug reaction (ADRs) remains a concern among the healthcare providers because of its unpredictable nature and the possibility to be life-threatening if left untreated. Carbamazepine and Phenytoin are commonly known to cause Steven-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). This report aims to summarise on Carbamazepine and Phenytoin -induced SJS/TEN and its association with HLA genes. It is apparent that HLA-B*15:02 and HLA-B*31:01 were the most important alleles responsible for SJS/TEN in reaction to Carbamazepine and Phenytoin. Together with suspected alleles and antiepileptics, a person may have a greater risk of experiencing ADRs rather than those people who do not carry any of the alleles. Pharmacogenetic testing can be implemented in clinical practices before prescription of these two antiepileptics to avoid such reactions.

Keywords: carbamazepine, HLA alleles, phenytoin, Steven Johnson Syndrome, Toxic Epidermal Necrolysis