Objective  To evaluate the accuracy, sensitivity, specificity and economy of HLA-B*5801 gene polymorphisms detection in predicting allopurinol-related severe drug eruption before receiving allopurinol treatment using rapid health technology assessment (rHTA), to provide clinicians and policymakers with an efficient and convenient evidence-based basis.

Methods  PubMed, Cochrane Library, Web of Science, Embase, WanFang Data, CNKI databases and the official website of health technology assessment (HTA) agency were electronically searched to collect HTA reports, systematic reviews/Meta-analyses and pharmacoeconomic literature on the HLA-B*5801 gene polymorphisms detection from inception to December 31, 2023. Two reviewers independently screened studies, extracted data, assessed the included studies' quality, and analyzed and summarised the results.  

Results  A total of 16 literature were included, of which 5 systematic reviews/Meta-analyses and 11 pharmacoeconomic studies. The results showed that the HLA-B*5801 gene mutation rate was significantly higher in patients presenting with severe drug eruption than in the allopurinol-tolerant group (P<0.05). Two studies reported the sensitivity and specificity of the HLA-B*5801 gene polymorphisms assay for predicting severe drug eruption, the sensitivity of 0.78, 0.93, and specificity of 0.96, 0.89, respectively. The economic study showed that HLA-B*5801 gene polymorphisms detection before allopurinol treatment was cost-effective in Chinese Han, Korean, Thai populations, but not in British, American (Caucasian or Hispanic), Singaporean and Malaysian populations.

Conclusion  HLA-B*5801 gene polymorphisms detection before allopurinol treatment and guiding drug use according to the screening results in Chinese Han population can reduce the risk of severe drug eruption and treatment costs.

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