Article ; Online: A Systematic Review of Efficacy and Safety of Monotherapy and Combination Therapy With Biologic for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis.
Journal of cutaneous medicine and surgery
2021 Volume 25, Issue 6, Page(s) 598–615
Abstract: Background: Biologic drugs have the potential to halt the progression of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) by decreasing concentrations of tumor necrosis factor-α, a cytokine implicated in epithelial cell death. The ... ...
Abstract | Background: Biologic drugs have the potential to halt the progression of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) by decreasing concentrations of tumor necrosis factor-α, a cytokine implicated in epithelial cell death. The objective of this systematic review is to investigate the efficacy and safety of biologic monotherapy and combination therapy for SJS/TEN. Methods: MEDLINE and EMBASE in OVID were searched on October 28, 2020. Inclusion criteria were original studies containing human participants diagnosed with SJS/TEN and treated with biologics. Studies were excluded if they were literature reviews, systematic reviews, letters to the editor, or conference abstracts. Results: The 38 articles reviewed included 27 (71.1%) case reports, 6 (15.8%) case series, 3 (7.9%) retrospective reviews, and 2 (5.3%) RCTs. The age range of the included studies was 2 to 85 years, the mean age was 46.4 years. The mean body surface (BSA) across the 38 included articles was 31.0%. The average actual mortality reported within the 38 included articles was 9.2%. Both biologic monotherapy and combination therapy were associated with improved outcomes in SJS/TEN. Furthermore, anti TNF-alpha therapy, specifically etanercept, showed improved outcomes as monotherapy. Conclusions: Overall, reviewed studies presented a strong case for biologic treatment, both monotherapy and combination use, in SJS/TEN treatment. Based on the number of fatal adverse events observed, biologic monotherapy may be safer compared to combination therapy. Further research with a larger sample size and a randomized control trial design is required. |
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MeSH term(s) | Biological Products/therapeutic use ; Disease Progression ; Drug Therapy, Combination ; Humans ; Stevens-Johnson Syndrome/drug therapy |
Chemical Substances | Biological Products |
Language | English |
Publishing date | 2021-02-25 |
Publishing country | United States |
Document type | Journal Article ; Systematic Review |
ZDB-ID | 1361720-5 |
ISSN | 1615-7109 ; 1203-4754 |
ISSN (online) | 1615-7109 |
ISSN | 1203-4754 |
DOI | 10.1177/1203475421993779 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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