Use of Etanercept in a Series of Pediatric Patients With Stevens-Johnson Syndrome–Toxic Epidermal Necrolysis Spectrum Disease

Reactive infectious mucocutaneous eruption – repeat etanercept after intravenous immunoglobulin: A case report

“…In an adult randomized controlled trial (RCT) of SJS/TEN, ETN showed benefit compared to corticosteroids for healing time. 17 Our patient received an initial dose of 0.6 mg/kg/dose SC based on the RCT dosing ( Table 5 ) with a significant stabilization in mucocutaneous lesions that seemed to reverse when IVIG was administered within 24 h. 5 , 18 , 17 Stabilization, when new skin lesions stop developing, is the goal of intervention, and thereafter, healing occurs naturally. We theorize that IVIG may have accelerated catabolism of ETN via saturation of the neonatal Fc receptor and neutralized ETN via anti-idiotypic antibodies that could bind to the Fc portion of ETN.…”

“…Our case highlights the overlapping features of RIME and MIS-C and the potential for treatment failure if both are simultaneously treated; that ETN efficacy can be recaptured with a second dose; and that early treatment can reduce chronic hyperpigmentation. 5,17,18,30,31,32 Source: Adapted from Ramien et al 25 IVIG: intravenous immunoglobulin; RIME: reactive infectious mucocutaneous eruption; TNF: tumour necrosis factor.…”

Evaluation of Etanercept for Treatment of Reactive Infectious Mucocutaneous Eruption

“…In this cohort study, we analyzed patients with RIME who were treated successfully with etanercept, a known medication for drug-related adult SJS and TEN and a recently suggested treatment for drug-related pediatric SJS and TEN. 5 Methods | This retrospective cohort study used medical record review for 6 patients who were admitted to Children's Hospital Los Angeles for RIME between June 1, 2018, and May 31, 2020. Patients were excluded if they had any medication exposure known to cause SJS and TEN.…”

Combined use of cyclosporine in the treatment of Stevens–Johnson syndrome/toxic epidermal necrolysis

“…Except for immunomodulatory drugs like glucocorticoids (GC) and i.v. immunoglobulin (IVIG), cyclosporine and anti‐tumor necrosis factor (TNF)‐α agents like etanercept are recently thought to be effective in SJS/TEN treatment 11–14 . Cyclosporine could effectively suppress lymphocyte function, 11 and etanercept is a TNF‐α receptor antagonist 14 .…”

“…immunoglobulin (IVIG), cyclosporine and anti-tumor necrosis factor (TNF)α agents like etanercept are recently thought to be effective in SJS/TEN treatment. [11][12][13][14] Cyclosporine could effectively suppress lymphocyte function, 11 and etanercept is a TNFα receptor antagonist. 14 Both are theoretically beneficial in the treatment of SJS/TEN, but etanercept is still in the clinical trials stage in the treatment of SJS/TEN.…”