ReportEffects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective study on patients included in the prospective EuroSCAR Study
Section snippets
Design and data collection
EuroSCAR was designed as a European case-control study evaluating risk factors for SJS or TEN. It was conducted in 6 countries (Austria, France, Germany, Israel, Italy, and the Netherlands) between April 1997 and December 2001. Patients studied were those admitted to hospital with a diagnosis of SJS or TEN, who were actively detected in a network of about 1800 hospitals covering more than 100 million inhabitants. After obtaining informed consent, trained investigators interviewed patients,
Results
A total of 513 potential patients with SJS or TEN were enrolled in the EuroSCAR study. In all, 379 of them were patients with validated SJS and TEN, who developed the reaction outside the hospital and who were admitted because of SCAR symptoms. In all, 130 were from France, 174 from Germany, and 75 from other countries. Among the 304 patients from France and Germany, additional data on agents administered for treatment of the reaction were completed in 281 (92%) of the patients, 125 of 130 from
Discussion
From 281 patients with SJS or TEN, we retrospectively collected data on treatment and separated the patients into 3 treatment groups (IVIG, IVIG + corticosteroids, corticosteroids–in addition to supportive care) and one control group that only received supportive care.
This was an observational study with the obvious limitations inherent in this type of study for evaluating therapeutic effects. The EuroSCAR study was not conceptually designed to analyze the effect of treatments. Furthermore, the
References (33)
Toxic epidermal necrolysis
Lancet
(1998)- et al.
Performance of SCORTEN during the first five days of hospitalization to predict the prognosis of toxic epidermal necrolysis
J Invest Dermatol
(2006) - et al.
Efficacy of cyclophosphamide in toxic epidermal necrolysis, clinical and pathophysiologic aspects
J Am Acad Dermatol
(1991) - et al.
Randomized comparison of thalidomide versus placebo in toxic epidermal necrolysis
Lancet
(1998) - et al.
Use of intravenous immunoglobulin in toxic epidermal necrolysis and Stevens-Johnson syndrome: Our current understanding
Int Immunopharmacol
(2006) - et al.
Toxic epidermal necrolysis: effector cells are drug-specific cytotoxic T cells
J Allergy Clin Immunol
(2004) - et al.
Toxic epidermal necrolysis: current evidence, practical management and future directions
Br J Dermatol
(2005) - et al.
Case records of the Massachusetts General Hospital, case 34-2005: a 10-year-old girl with a bullous skin eruption and acute respiratory failure
N Engl J Med
(2005) - et al.
Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study
Arch Dermatol
(2002) - et al.
Medication use and the risk of Stevens-Johnson syndrome or toxic epidermal necrolysis
N Engl J Med
(1995)
A clinical classification of cases of toxic epidermal necrolysis, Stevens-Johnson syndrome and erythema multiforme
Arch Dermatol
Cutaneous adverse drug reactions. Stevens-Johnson syndrome and toxic epidermal necrolysis
ACI International
SCORTEN: a severity-of-illness score for toxic epidermal necrolysis
J Invest Dermatol
Drug-induced toxic epidermal necrolysis treated with cyclosporin
Int J Dermatol
Treatment of toxic epidermal necrolysis with cyclosporin A
J Trauma
Improved burn center survival of patients with toxic epidermal necrolysis managed without corticosteroids
Ann Surg
Cited by (399)
APOA4 as a novel predictor of prognosis in Stevens-Johnson syndrome/toxic epidermal necrolysis: A proteomics analysis from two prospective cohorts
2023, Journal of the American Academy of DermatologyClinical aspects and therapeutic approach of drug-induced adverse skin reactions in a quaternary hospital: a retrospective study with 219 cases
2022, Anais Brasileiros de DermatologiaAdvances in the Pathomechanisms of Delayed Drug Hypersensitivity
2022, Immunology and Allergy Clinics of North AmericaEvaluation of Combination Therapy With Etanercept and Systemic Corticosteroids for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Multicenter Observational Study
2022, Journal of Allergy and Clinical Immunology: In Practice
The following institutions/companies funded the EuroSCAR project (unrestricted grants): ADIR and Cie, Bayer Pharma/AG/Vital, Boehringer Ingelheim, Cassenne, Ciba Geigy/Novartis, Cilag GmbH, Dr Willmar Schwabe, Goedecke Parke Davis, Glaxo Wellcome/GlaxoSmithKline, Hoechst AG/Hoechst Marion Roussel/Aventis, Hoffmann-La-Roche, IRIS Servier, Jouveinal Lab, LEO, LILLY, MSD Sharp and Dohme, Pfizer, Rhone Poulenc Rorer, Sanofi Winthrop/Sanofi Synthelabo GmbH, and Schering AG. Funding from pharmaceutical companies in France was managed through contract with Institut National de la Santé et de la Recherche Médicale, French Ministry of Health (PHRC AOM 98027); GIS-Institut des Maladies Rares.
Conflicts of interest: None declared.
Presented orally or in poster form at Journées Dermatologiques de Paris, France, December 2-6, 2003, and European Society for Dermatological Research, Austria, Vienna, September 8-9, 2004.