Rapid remission of Stevens-Johnson syndrome by combination therapy using etanercept and intravenous immunoglobulin and a review of the literature

Wang, Ruojun; Zhong, Shaomin; Tu, Ping; Li, Ruoyu; Wang, Mingyue

doi:10.1111/dth.12832

Cited by 19 publications

(6 citation statements)

References 13 publications

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“…As a result, there is no established standard of care pertaining to pharmacologic treatment. Due to the immunologic nature of the disease, it is believed that immunosuppressive therapies will aid in treatment, and many case reports have reported positive results with varying treatment regimens involving different combinations of corticosteroids, IVIg, cyclosporine, and TNF-alpha inhibitors [ 21 , 78 , 79 , 80 , 81 ]. However, it is difficult to determine if disease remission was due to specific treatment or simply the natural history of the disease.…”

Section: Clinical Updatesmentioning

confidence: 99%

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

et al. 2021

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Stevens–Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare diseases that are characterized by widespread epidermal necrosis and sloughing of skin. They are associated with significant morbidity and mortality, and early diagnosis and treatment is critical in achieving favorable outcomes for patients. In this scoping review, Excerpta Medica dataBASE and PubMed were searched for publications that addressed recent advances in the diagnosis and management of the disease. Multiple proteins (galectin 7 and RIP3) were identified that are promising potential biomarkers for SJS/TEN, although both are still in early phases of research. Regarding treatment, cyclosporine is the most effective therapy for the treatment of SJS, and a combination of intravenous immunoglobulin (IVIg) and corticosteroids is most effective for SJS/TEN overlap and TEN. Due to the rare nature of the disease, there is a lack of prospective, randomized controlled trials and conducting these in the future would provide valuable insights into the management of this disease.

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Section: Clinical Updatesmentioning

confidence: 99%

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

et al. 2021

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“…[ 66 ] China Case report SJS 1 Etanercept IVIG Combined Wang et al. [ 67 ] China Case report SJS-TEN overlap 1 Etanercept Corticosteroids + IVIG Combined Wojtkiewicz et al. [ 68 ] Poland Case report TEN 1 Infliximab Corticosteroids + supportive therapy Combined Worsnopet al.…”

Section: Resultsmentioning

confidence: 99%

Biologic TNF-α Inhibitors for Stevens–Johnson Syndrome, Toxic Epidermal Necrolysis, and TEN-SJS Overlap: A Study-Level and Patient-Level Meta-Analysis

Cao

Zhang

Xing

et al. 2023

Dermatol Ther (Heidelb)

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Introduction Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions with high morbidity and mortality and not clearly established treatment protocol. This meta-analysis aimed to evaluate the efficacy and safety of three biologic TNF-α inhibitors (infliximab, etanercept, adalimumab) in the treatment of SJS, SJS-TEN overlap, and TEN. Methods Electronic databases were searched for original studies containing human participants diagnosed with SJS/TEN and treated with biologic TNF-α inhibitors. Individual patient data were collected and summarized to provide a comprehensive overview on therapeutic efficacy of different biologic TNF-α inhibitors for SJS, SJS-TEN overlap, and TEN, respectively. Meta-analyses on aggregated study data were conducted using random-effects model. Results Overall, 55 studies with 125 sets of individual patient data were included. Infliximab was used to treat 3 patients with SJS-TEN overlap and 28 patients with TEN, and the actual mortality rate was 33.3% and 17%, respectively. Etanercept was administered to 17 patients with SJS, 9 patients with SJS-TEN overlap, and 64 patients with TEN, and mortality rate was reported to be 0%, 0%, and 12.5%, respectively. For participants with TEN, no significant difference was found in time of reepithelialization, hospitalization time, and mortality rate comparing etanercept with infliximab. More sequelae were reported in patients receiving infliximab than in patients treated with etanercept (39.3% versus 6.4%). Adalimumab was administered to four patients with TEN, and mortality rate was 25%. Meta-analyses on aggregated study data revealed significantly shortened hospitalization time in etanercept compared with non-etanercept groups [weighted mean differences (WMD) −5.30; 95% confidence interval (CI) −8.65 to −1.96]. Etanercept was associated with a survival benefit for patients when compared with non-etanercept treatment, however, the analysis was not statistically significant (odds ratio 0.55; 95% CI 0.23–1.33). Conclusions On the basis of the current findings, etanercept is currently the most promising biologic therapy for SJS/TEN. Further evaluation in prospective studies is required to confirm its efficacy and safety. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-023-00928-w.

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“…Como resultado, no existe un estándar de atencion establecido relacionado con el tratamiento farmacológico. Debido a la naturaleza inmunológica de la enfermedad, se cree que las terapias inmunosupresoras ayudarán en el tratamiento, y muchos informes de casos han reportado resultados positivos con diferentes regímenes de tratamiento que involucran diferentes combinaciones de corticosteroides, IgIV, ciclosporina e inhibidores de TNF-alfa (21,78,79,80,81).…”

Section: Tratamiento Farmacológicounclassified

Revisión Sistematica sobre el Diagnostico Diferencial y Manejo de 2 Entidades Dentro del Mismo Espectro de las Toxicodermias Graves, Stevens–Johnson y Necrolisis Epidérmica Toxica

Pérez Alquichire,

González Martínez,

González Fuentes

et al. 2024

Ciencia Latina

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El síndrome de Stevens-Johnson (SSJ) y la necrólisis epidérmica tóxica (NET) son enfermedades raras que se caracterizan por necrosis epidérmica generalizada y desprendimiento de la piel. Se asocian con una morbilidad y mortalidad significativas, y el diagnóstico y tratamiento tempranos son fundamentales para lograr resultados favorables para los pacientes. En esta revisión se abordaran los avances recientes en el diagnóstico y tratamiento de la enfermedad. Se identificaron múltiples proteínas (galectina 7 y RIP3) que son biomarcadores poNETciales prometedores para SSJ/NET, aunque ambos aún se encuentran en fases iniciales de investigación. En cuanto al tratamiento, la ciclosporina es la terapia más eficaz para el tratamiento del SSJ, y una combinación de inmunoglobulina intravenosa (IVIg) y corticosteroides es más eficaz para la superposición SSJ/NET y NET. Debido a la naturaleza rara de la enfermedad, hay una falta de ensayos controlados aleatorios prospectivos y realizarlos en el futuro proporcionaría información valiosa sobre el tratamiento de esta enfermedad.

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Rapid remission of Stevens-Johnson syndrome by combination therapy using etanercept and intravenous immunoglobulin and a review of the literature

Cited by 19 publications

References 13 publications

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis: A Review of Diagnosis and Management

Biologic TNF-α Inhibitors for Stevens–Johnson Syndrome, Toxic Epidermal Necrolysis, and TEN-SJS Overlap: A Study-Level and Patient-Level Meta-Analysis

Revisión Sistematica sobre el Diagnostico Diferencial y Manejo de 2 Entidades Dentro del Mismo Espectro de las Toxicodermias Graves, Stevens–Johnson y Necrolisis Epidérmica Toxica

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