Cyclosporine treatment for Stevens-Johnson syndrome/toxic epidermal necrolysis: Retrospective analysis of a cohort treated in a specialized referral center

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• 作者：Haur Yueh Lee ; MRCP^a ; ^c ; ^d ; ^{lee.haur.yueh@singhealth.com.sg} ; Stephanie Fook-Chong ; MSc ; CStat^b ; Hong Yi Koh ; MRCP^a ; ^d ; Tharmotharampillai Thirumoorthy ; FRCP^a ; ^d ; Shiu Ming Pang ; FRCP^a ; ^d
• 关键词：cyclosporine ; SCORTEN ; Stevens-Johnson syndrome ; toxic epidermal necrolysis
• 刊名：Journal of the American Academy of Dermatology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：76
• 期：1
• 页码：106-113
• 全文大小：255 K
• 卷排序：76

文摘

Treatment of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) remains controversial.ObjectiveWe sought to evaluate the impact of cyclosporine on hospital mortality in patients with SJS/TEN.MethodsAll patients with SJS and TEN admitted to our center from 2011 to 2014 were treated under a standardized protocol that allowed for cyclosporine therapy if the inclusion and exclusion criteria were met. Clinical data were reviewed retrospectively. Comparative analysis was made on mortality outcomes with patients treated with cyclosporine versus what was expected based on SCORTEN.ResultsIn all, 44 patients were admitted during the study period. A total of 24 patients received cyclosporine and the remaining 20 patients were treated supportively. SCORTEN predicted 7.2 deaths and 3 were observed in the group treated with cyclosporine. In the group treated supportively, SCORTEN predicted 5.9 deaths and 6 deaths were observed. The standardized mortality ratio of SJS/TEN treated with cyclosporine was 0.42 (95% confidence interval 0.09-1.22).LimitationSmall sample size, retrospective design, and referral bias are limitations.ConclusionThe use of cyclosporine may improve mortality in SJS/TEN and needs to be validated in controlled studies.