Basic & Clinical Pharmacology & Toxicology最新文献

{"title":"Studying Deprescribing Using Routinely Collected Healthcare Data: Old Challenges and New Opportunities","authors":"Jonas W. Wastesson, Karl-Hermann Sielinou Kamgang, Carina Lundby, Anton Pottegård","doi":"10.1111/bcpt.70131","DOIUrl":"10.1111/bcpt.70131","url":null,"abstract":"<p>In routinely collected healthcare data, deprescribing is in most cases indistinguishable from drug discontinuation. This is not a minor technical challenge; it is a fundamental limitation in most routinely collected data sources, such as dispensing data, electronic health records and registries. Deprescribing is only a subset of discontinuation, defined by its intentionality, clinical supervision and patient perspective: ‘Deprescribing is the process of withdrawal of an inappropriate medication, supervised by a healthcare professional with the goal of managing polypharmacy and improving outcomes’ [<span>1</span>]. Supervision by clinicians and goal-setting with patients are defining features, yet they remain invisible in routinely collected data. Any attempt to identify deprescribing without acknowledging this constraint risks conflating clinical decision-making with other reasons for discontinuation such as patient adherence issues. This paper reflects on how creative use of routinely collected data may nevertheless further our understanding of the impact of deprescribing and, on occasion, allow distinguishing deprescribing from other forms of discontinuation.</p><p>There is a need for observational studies in deprescribing research. Large-scale deprescribing trials are unlikely, as most trials depend on pharmaceutical industry funding and deprescribing lacks commercial incentive. Hence, registry studies (routinely collected administrative health care data) remain one of the few options for studying deprescribing at scale [<span>2</span>]. Although this function is constrained by the inability to distinguish deprescribing from other forms of discontinuation in routinely collected data, creative use of data and design can overcome some challenges.</p><p>We acknowledge calls for stricter conceptual clarity in the use of the term deprescribing, emphasizing shared decision-making and structured follow-up [<span>3</span>]. This definition is typically achievable in intervention studies. However, in pharmacoepidemiologic research, such detailed process elements are rarely observable. If conceptual criteria were applied rigidly, most register-based studies would be excluded from deprescribing research. We take a more pragmatic view. When the aim is to study deprescribing, even without full access to process details, it is reasonable to use the term, provided the operational definition is clearly stated and its limitations acknowledged. This allows the research to stay conceptually focused while contributing to the broader evidence base.</p><p>The challenges of identifying deprescribing are not new to the field of pharmacoepidemiology and can be summarized as below.</p><p>The key challenges of identifying deprescribing should not discourage researchers from studying this in routinely collected data. Rather, we argue that careful use of data can move the deprescribing field forward.</p><p>An alternative to the approach of enriching data is to find exa","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12516172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Brief Mindfulness-Informed Cognitive–Behavioural Therapy Intervention to Pair With Pharmacist-Led Benzodiazepine Tapering for Older Adults: The CSTARS Intervention","authors":"Kristen M. Kraemer,&nbsp;Brianna Wang,&nbsp;Marissa McCann,&nbsp;Julia Lindenberg,&nbsp;Timothy S. Anderson,&nbsp;Gloria Y. Yeh","doi":"10.1111/bcpt.70128","DOIUrl":"10.1111/bcpt.70128","url":null,"abstract":"<div>\u0000 \u0000 <p>Benzodiazepines are potentially inappropriate medications for older adults, and deprescribing interventions are needed. We describe the development of a psychologist-led, mindfulness-informed cognitive–behavioural therapy (CBT) intervention to pair with pharmacist-led tapering to support benzodiazepine deprescribing in older adults. Based on previous research, we first developed an intervention conceptual model. The aim of this study was to (1) gather stakeholder feedback on previous experiences with benzodiazepine tapering and on our intervention model and proposed intervention, and (2) integrate this qualitative feedback to develop an intervention manual. We conducted (a) semistructured individual interviews with older adults (<i>N</i> = 8) who previously attempted to taper their benzodiazepines, and (b) a focus group with members (<i>N</i> = 5) from a national deprescribing patient stakeholder group. Overlapping themes emerged, including support for the mindfulness-informed CBT intervention, the importance of control over taper pace, the need for a goal- and skills-oriented intervention, the importance of normalizing side effects of the taper and building confidence to manage side effects and the utility of fostering acceptance during the taper. These findings informed the development of a final intervention manual, named <span>C</span>onfidence-Building <span>St</span>r<span>a</span>tegies for <span>R</span>educing <span>S</span>edative Medications (CSTARS), to be tested in a single-arm pilot feasibility trial.</p>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Treatment Beyond the Scale: Clinical Reflections on Obesity Management and Anti-Obesity Medicines","authors":"Andrej Belančić","doi":"10.1111/bcpt.70130","DOIUrl":"10.1111/bcpt.70130","url":null,"abstract":"","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrochemical Point-of-Care Test for Assessing Serum Paracetamol Concentration: Comparison With Traditional Methods and Detection of Concomitant Drugs","authors":"Johanna K. Kujala,&nbsp;Terhi J. Lohela,&nbsp;Niklas Wester,&nbsp;Elsi Verrinder,&nbsp;Anna Pelander,&nbsp;Tea Lamberg,&nbsp;Björn Mikladal,&nbsp;Eija A. Kalso,&nbsp;Tuomas O. Lilius","doi":"10.1111/bcpt.70127","DOIUrl":"10.1111/bcpt.70127","url":null,"abstract":"<p>Rapid serum paracetamol (acetaminophen) concentration measurement is essential in suspected intoxication, but centralized laboratory analyses often delay initiation of antidotal therapy. We studied the feasibility of a novel electrochemical single-walled carbon nanotube/Nafion-based point-of-care (POC) method in detecting paracetamol in 99 suspected overdose patient serum samples. POC was compared with the standard photoelectric enzymatic method (PEM) and ultra-high performance liquid chromatography–photodiode array and corona-charged aerosol detector (UHPLC-DAD-CAD). We also analysed for 900 concomitant pharmaceuticals, drugs and chemicals in 197 samples with time-of-flight mass spectrometry to assess interference with paracetamol concentration measurements. Paracetamol concentrations measured with UHPLC-DAD-CAD ranged between 0 and 2100 μmol/L, with 19% above the therapeutic level (≥ 200 μmol/L). Comparing POC with UHPLC-DAD-CAD, the false positives and negatives were 10% and 15%, respectively, at concentrations ≥ 30 μmol/L. All POC method false negatives occurred at concentrations &lt; 45 μmol/L. PEM showed 8% false positives and negatives compared with UHPLC-DAD-CAD. Other substances detected included caffeine (78%), antidepressants (41%), benzodiazepines (34%) and antipsychotics (28%). They did not interfere with POC concentration measurement. The novel POC method is promising for measuring serum paracetamol at relevant concentrations.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality Assessment of Therapeutic Drug Monitoring Assays of Therapeutic Antibodies Across Europe: An Update","authors":"James Bluett,&nbsp;Merita Rumano,&nbsp;María José Martínez Becerra,&nbsp;Floris Loeff,&nbsp;Mehmet Itik,&nbsp;David Ternant,&nbsp;Céline Desvignes,&nbsp;Denis Mulleman,&nbsp;Silje Skrede","doi":"10.1111/bcpt.70129","DOIUrl":"10.1111/bcpt.70129","url":null,"abstract":"<p>Immune mediated inflammatory diseases (IMIDs) are common, chronic, inflammatory diseases. There has been an expansion of monoclonal antibodies to treat the disease. However, the response is not universal; reasons for non-response may include suboptimal drug concentrations for which therapeutic drug monitoring (TDM) may lead to improved outcomes. Several laboratory assays are available to measure biologic drug concentrations, but variation in assay accuracy may introduce bias. External quality assessments (EQA) provide assurance of the performance of a laboratory test. The aim of this work was to survey current quality assessment procedures that are in place in laboratories undertaking TDM of therapeutic antibodies for the treatment of IMIDs to guide clinical decision making across Europe. A survey was sent out to institutions undertaking TDM across Europe. In total, 26 institutions responded; the vast majority (96.2%) of institutions utilize an internal quality control, with 42% of institutions not reporting participation in a national EQA scheme. Barriers to EQA participation included insufficient information about relevant organizations and financial constraints. These results demonstrate that, although TDM assay performance is well controlled locally, better access to EQA and standards may further aid the translatability of results between laboratories and aid the adoption of published reference values.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of Perceptions of Deprescribing Practices Among Doctors in a Low- and Middle-Income Country: A Mixed-Methods Study","authors":"Anjan Khadka,&nbsp;Sammodavardhana Kaundinnyayana,&nbsp;Kumar Roka,&nbsp;Arjun Poudel,&nbsp;Shakti Shrestha","doi":"10.1111/bcpt.70121","DOIUrl":"10.1111/bcpt.70121","url":null,"abstract":"<p>With the increasing prevalence of potentially inappropriate medications in low- and middle-income countries (LMICs) like Nepal, the role of deprescribing is ever important. However, evidence on how Nepalese doctors perceive deprescribing in their practice is lacking. A sequential explanatory mixed-method study was conducted among 115 doctors at a tertiary-level teaching hospital in central Nepal using a structured questionnaire. Quantitative data from Likert-scale items were analysed descriptively, while thematically analysing open-ended responses. Only 45 doctors (39.1%) had heard of deprescribing, and 77.8% reported practising it. Most doctors (80%) understood the rationale behind each prescription, and 94.3% agreed on ensuring patient comprehension of prescribed medicines. Only 52.4% routinely involved patients in deprescribing decisions, and 31.4% acknowledged prescribing ‘too many drugs’ at times. Qualitative analysis identified three deprescribing-related themes: (1) general understanding: deprescribing viewed as a planned, systematic process to optimize treatment, minimize polypharmacy, reduce costs, and improve safety; (2) Enablers: patient factors, treatment considerations, medication issues, disease process, prescriber competencies and institutional support; (3) barriers: patient resistance, prescribing inertia, knowledge gaps, coordination issues, time constraints, cost and pharmaceutical influences. Doctors demonstrated a moderate understanding of deprescribing but faced several contextual challenges, highlighting the need for targeted education, institutional policies and deprescribing frameworks in LMICs.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12497502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjustment for ‘Prescriber Type’ in Pharmacoepidemiological Analyses","authors":"Saad Hanif Abbasi,&nbsp;Jesper Hallas,&nbsp;Peter Bjødstrup Jensen,&nbsp;Hassan Al-Jasim,&nbsp;Anton Pottegård","doi":"10.1111/bcpt.70126","DOIUrl":"https://doi.org/10.1111/bcpt.70126","url":null,"abstract":"<p>The type of prescriber typically fulfils the criteria for confounding, as it is associated both with the exposure (e.g., prescriber types may differ in their choice of first-line treatment) and with the outcome (as different types of prescribers often treat patients with different disease severity). Additionally, the type of prescriber may correlate with other factors such as treatment adherence, surveillance or coding practices. Although information on the type of prescriber is often available in healthcare registries, it is very rarely employed to control for confounding in pharmacoepidemiological analyses. Here, we argue the potential value in adjusting for the prescriber type in pharmacoepidemiological studies. In an applied example, we conducted a cohort study using Danish healthcare registers of the risk of ischemic stroke associated with the use of direct oral anticoagulants (DOACs) compared to warfarin. We found a hazard ratio (HR) of 0.95 (95% CI: 0.90–1.01) for DOACs versus warfarin when adjusting only for age and sex. Further adjustment for prescriber type showed an effect of similar magnitude (HR 0.92; 95% CI: 0.87–0.98). However, interaction testing and stratified analyses confirmed prescriber type as an effect modifier. Future studies are needed to clarify the role of adjusting for prescriber type across other use cases and healthcare settings.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/bcpt.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyanide Beyond Toxicity: A Systematic Review of Its Effects on Vascular Function","authors":"Elif Alan-Albayrak,&nbsp;Ulf Simonsen","doi":"10.1111/bcpt.70124","DOIUrl":"10.1111/bcpt.70124","url":null,"abstract":"<p>Cyanide is widely recognized for its potent toxicity, yet evidence shows that concentrations below 1 μM may enhance cytochrome c oxidase activity and have a regulatory function. Recent findings also demonstrate that mammalian cells, including endothelial cells, produce cyanide endogenously, where it can modulate mitochondrial bioenergetics. However, the vascular implications of this endogenous production remain unexplored. The review addresses this gap and evaluates the vascular effects of glycine, a proposed substrate for endogenous cyanide synthesis. This systematic review was conducted in accordance with PRISMA 2020 guidelines. Seventy-eight studies were included. Eligible studies with quantifiable vascular outcomes were screened and synthesized. Exogenous cyanide elicited vascular responses through mitochondrial inhibition, modulation of calcium signalling and interference with the soluble guanylyl cyclase/cyclic guanosine monophosphate pathway. Subchronic low-dose in vivo cyanide exposure reduced contractions and enhanced relaxation in endothelium-denuded aortic rings. Collectively, evidence indicates a biphasic pattern: high concentrations are cytotoxic, whereas low concentrations may exert protective/regulatory effects. Low-dose cyanide may have therapeutic potential in managing vascular disorders associated with endothelial dysfunction. Determining an effective and safe dosage range is crucial, and further studies are needed to clarify the role of endogenous cyanide in regulating vascular function.</p>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence in the Treatment of Inflammatory Bowel Disease With Particular Focus on the Importance of the Clinical Pharmacist: A Systematic Review","authors":"Faria Sayed,&nbsp;Mark Andrew Ainsworth","doi":"10.1111/bcpt.70125","DOIUrl":"10.1111/bcpt.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of inflammatory bowel disease (IBD) is increasing. While several studies have shown that incorporating a clinical pharmacist into patient care can improve quality of life, evidence specifically addressing their role in IBD management remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to systematically review the evidence on treatment adherence in IBD, with a focus on the potential role of clinical pharmacist counselling to improve medication adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three databases (PubMed, MEDLINE and Embase) were searched to identify relevant literature, using keywords derived from the PICO model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven full-text articles met the inclusion criteria. Three of these reported that pharmacist involvement had a positive effect on treatment adherence in patients with IBD. Furthermore, two studies reported that pharmacist involvement in treatment improved disease activity. Patients' perceptions of pharmacist involvement were generally positive, particularly after receiving information about pharmacist services and education. Finally, studies also indicate that pharmacists require greater knowledge of IBD to provide optimal care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the available literature is limited, it indicates that involving clinical pharmacists in IBD treatment may have a positive impact—improving medication adherence and enhancing disease control.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of HLA-B*53 With DRESS Syndrome in Patients Treated With Raltegravir: Two Case Reports and a Literature Review","authors":"Cristina Ramos-Del Moral,&nbsp;Pablo Rodríguez Cortés,&nbsp;Marcos Navares-Gómez,&nbsp;Diana Campodónico,&nbsp;Susana Almenara de Riquer,&nbsp;Ana Barrios Blandino,&nbsp;Gina Mejía-Abril,&nbsp;Antía Gómez-Fernández,&nbsp;Olga Romero Sastre,&nbsp;Patricia Carles García,&nbsp;Francisco Abad-Santos","doi":"10.1111/bcpt.70118","DOIUrl":"10.1111/bcpt.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Raltegravir, an HIV integrase inhibitor, although generally well tolerated, may cause severe reactions such as drug reaction with eosinophilia and systemic symptoms (DRESS). This syndrome has been associated with impaired drug metabolism, viral reactivation and genetic factors including <i>HLA-B*53:01</i>. We describe two cases of DRESS in a raltegravir-treated cohort and review the relevant literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Medical records from Hospital Universitario de La Princesa (2008–2020) were retrospectively reviewed to identify patients genotyped for <i>HLA-B*53</i> who received raltegravir. Suspected DRESS cases were assessed using the RegiSCAR scoring system and Naranjo algorithm. A structured literature search was conducted to identify additional published cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 109 patients treated with raltegravir, three (2.8%) were <i>HLA-B*53</i> carriers. Two developed DRESS, while no events occurred in non-carriers. One presented with fever, rash, lymphadenopathy, hepatitis and HHV-6 reactivation (RegiSCAR 6). The second developed eosinophilia, rash and pulmonary symptoms (RegiSCAR 4). The third carrier remained asymptomatic. A continuity correction yielded a RR of 133.9. Nine additional cases were identified in the literature and summarized according to clinical features and <i>HLA-B*53</i> status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings support a potential genetic predisposition involving <i>HLA-B*53:01</i> in raltegravir-induced DRESS. Screening in high-prevalence populations may help prevent severe reactions. Further research should refine diagnostic and management strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8733,"journal":{"name":"Basic & Clinical Pharmacology & Toxicology","volume":"137 5","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}