Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the FDA Adverse Event Reporting System (FAERS) from 1995-2020

Krantz, Matthew S.; Yoon, Brian; Stone, Cosby A.; Yu, Roger; Phillips, Elizabeth

doi:10.1016/j.jaci.2021.12.233

Cited by 3 publications

(3 citation statements)

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“…In addition to carriage of the HLA‐A*32:01 allele risk factors have included age lower than 50 and higher vancomycin through level 87,161 . The top causes of both DRESS and SJS/TEN have remained stable over the last 15 years 162,163 . Increasing recognition of drugs used in immunotherapy of cancers particularly in the developed world have highlighted that drugs such as immune checkpoint inhibitors and other immunotherapies can cause SJS/TEN like illness and autoimmune bullous diseases, DRESS, and AGEP.…”

Section: Scars and Global Epidemiology In Relation To Genetic Riskmentioning

confidence: 99%

“…87,161 The top causes of both DRESS and SJS/TEN have remained stable over the last 15 years. 162,163 Increasing recognition of drugs used in immunotherapy of cancers particularly in the developed world have highlighted that drugs such as immune checkpoint inhibitors and other immunotherapies can cause SJS/TEN like illness and autoimmune bullous diseases, DRESS, and AGEP. Lichenoid bulloid eruptions can mimic SJS/TEN clinically; however, they tend to evolve more slowly and are distinct on histopathology.…”

Section: Sc Ar S and G Lobal Epidemi Ology In Rel Ati On To G Ene Tic...mentioning

confidence: 99%

See 1 more Smart Citation

Changing patterns in the epidemiology of drug allergy

Doña,

Torres,

Celik

et al. 2023

Allergy

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Drug allergy (DA) remains a complex and unaddressed problem worldwide that often deprives patients of optimal medication choices and places them at risk for life‐threatening reactions. Underdiagnosis and overdiagnosis are common and due to the lack of standardized definitions and biomarkers. The true burden of DA is unknown, and recent efforts in data gathering through electronic medical records are starting to provide emerging patterns around the world. Ten percent of the general population engaged in health care claim to have a DA, and the most common label is penicillin allergy. Up to 20% of emergency room visits for anaphylaxis are due to DA and 15%–20% of hospitalized patients report DA. It is estimated that DA will increase based on the availability and use of new and targeted antibiotics, vaccines, chemotherapies, biologicals, and small molecules, which are aimed at improving patient's options and quality of life. Global and regional variations in the prevalence of diseases such as human immunodeficiency virus and mycobacterial diseases, and the drugs used to treat these infections have an impact on DA. The aim of this review is to provide an update on the global impact of DA by presenting emerging data on drug epidemiology in adult and pediatric populations.

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Section: Scars and Global Epidemiology In Relation To Genetic Riskmentioning

confidence: 99%

Section: Sc Ar S and G Lobal Epidemi Ology In Rel Ati On To G Ene Tic...mentioning

confidence: 99%

Changing patterns in the epidemiology of drug allergy

Doña,

Torres,

Celik

et al. 2023

Allergy

View full text Add to dashboard Cite

show abstract

“…The incidence of SJS/TEN is estimated at 2–7 cases per million people per year using a German population based-registry with an increase prevalence of SJS cases compared to TEN ( 47 , 48 ). Recently, data from the FDA adverse event reporting system (FAERS) indicated a rate of 0.15% with 30,202 reactions among the 20,406,852 adverse drug events reported in the database ( 49 ). In lower- and middle-income countries where TB and HIV are more prevalent, the rates of SJS/TEN are up to 10-fold higher ( 10 ).…”

Section: Delayed Hypersensitivity Reactionsmentioning

confidence: 99%

Tools to improve the diagnosis and management of T-cell mediated adverse drug reactions

2022

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Delayed drug T-cell immune-mediated hypersensitivity reactions have a large clinical heterogeneity varying from mild maculopapular exanthema (MPE) to severe cutaneous adverse reactions (SCARs) such as acute generalized exanthematous pustulosis (AGEP), drug reaction with eosinophilia and systemic symptoms (DRESS) and severe skin necrosis and blistering as seen in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Given the knowledge gaps related to the immunopathogenesis of these conditions, the absence of validated diagnostic tools and the significant associated morbidity and mortality, patients with SCARs often have limited drug choices. We performed a comprehensive review aiming to evaluate in vivo diagnostic tools such as delayed intradermal skin and patch testing and ex vivo/in vitro research assays such as the lymphocyte transformation test (LTT) and the enzyme-linked ImmunoSpot (ELISpot) assay. We searched through PubMed using the terms “drug allergy,” “in vivo” and “ex vivo” for original papers in the last 10 years. A detailed meticulous approach adapted to the various clinical phenotypes is recommended for the diagnostic and management of delayed drug hypersensitivity reactions. This review highlights the current diagnostic tools for the delayed drug hypersensitivity phenotypes.

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Multiomic single-cell sequencing defines tissue-specific responses in Stevens-Johnson syndrome and toxic epidermal necrolysis

Gibson,

Ram,

Gangula

et al. 2024

Nat Commun

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Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) is a rare but life-threatening cutaneous drug reaction mediated by human leukocyte antigen (HLA) class I-restricted CD8 + T cells. For unbiased assessment of cellular immunopathogenesis, here we perform single-cell (sc) transcriptome, surface proteome, and T cell receptor (TCR) sequencing on unaffected skin, affected skin, and blister fluid from 15 SJS/TEN patients. From 109,888 cells, we identify 15 scRNA-defined subsets. Keratinocytes express markers indicating HLA class I-restricted antigen presentation and appear to trigger the proliferation of and killing by cytotoxic CD8 + tissue-resident T cells that express granulysin, granzyme B, perforin, LAG3 , CD27 , and LINC01871 , and signal through the PKM , MIF , TGFβ , and JAK-STAT pathways. In affected tissue, cytotoxic CD8 + T cells express private expanded and unexpanded TCRαβ that are absent or unexpanded in unaffected skin, and mixed populations of macrophages and fibroblasts express pro-inflammatory markers or those favoring repair. This data identifies putative cytotoxic TCRs and therapeutic targets.

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Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in the FDA Adverse Event Reporting System (FAERS) from 1995-2020

Cited by 3 publications

References 0 publications

Changing patterns in the epidemiology of drug allergy

Changing patterns in the epidemiology of drug allergy

Tools to improve the diagnosis and management of T-cell mediated adverse drug reactions

Multiomic single-cell sequencing defines tissue-specific responses in Stevens-Johnson syndrome and toxic epidermal necrolysis

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