Effects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective study on patients included in the prospective EuroSCAR Study - 24/04/13
Abstract |
Background |
No treatment modality has been established as standard for patients with Stevens-Johnson syndrome and toxic epidermal necrolysis.
Objective |
We sought to evaluate the effect of treatment on mortality in a large cohort of patients with Stevens-Johnson syndrome or toxic epidermal necrolysis.
Methods |
Data on therapy were retrospectively collected from patients in France and Germany enrolled in EuroSCAR, a case-control study of risk factors.
Results |
Neither intravenous immunoglobulins nor corticosteroids showed any significant effect on mortality in comparison with supportive care only. Compared with supportive care, odds ratios for death were 1.4 (95% confidence interval: 0.6-4.3) for intravenous immunoglobulins in France and 1.5 (0.5-4.4) in Germany, and 0.4 (0.1-1.7) for corticosteroids in France and 0.3 (0.1-1.1) in Germany.
Limitations |
Such an observational study with retrospective data collection has obvious limitations, including heterogeneity between the countries, supportive care, treatment doses, and durations.
Conclusions |
We found no sufficient evidence of a benefit for any specific treatment. The trend for a beneficial effect of corticosteroids deserves further exploration.
Le texte complet de cet article est disponible en PDF.Abbreviations used : IVIG, OR, SCAR, SJS, TEN
Plan
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. |
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Conflicts of interest: None declared. |
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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. |
Vol 58 - N° 1
P. 33-40 - janvier 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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