Open AccessEvaluation of the Effectiveness of Therapy for Stevens−Johnson Syndrome and Toxic Epidermal Necrolysis: A Review
Author(s) -
Anfisa A. Lepekhova,
Лепехова Анфиса Александровна,
Anastasiia Allenova,
Алленова Анастасия Сергеевна,
Olga Yu. Olisova,
Олисова Ольга Юрьевна,
Nataliа P. Teplyuk,
Теплюк Наталия Павловна,
Elizaveta V. Kanareikina,
Канарейкина Елизавета Вячеславовна
Publication year - 2019
Publication title -
vestnik rossijskoj akademii medicinskih nauk
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.122
H-Index - 15
eISSN - 2414-3545
pISSN - 0869-6047
DOI - 10.15690/vramn1051
Subject(s) - medicine , toxic epidermal necrolysis , thalidomide , concomitant , infliximab , cochrane library , sepsis , erythroderma , disease , systemic therapy , randomized controlled trial , oncology , cancer , dermatology , multiple myeloma , breast cancer
39 original articles were analyzed. 8 of them were excluded due to the small sample of patients. The effectiveness of the intravenous Ig, systemic glucocorticosteroids, cyclosporin A, biological agents (etranecept, infliximab, thalidomide) on the basis of the SCORTEN scale and the number of lethal outcomes was evaluated. Information was searched for the following databases: PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Cochrane Library. The systemic glucocorticosteroid (GCs) pulse therapy using only in the phase of disease progression was the most appropriate. Some authors showed a high risk of sepsis development in patients treated with GCs. In patients who received high doses of IVIg (2 g/ kg), mortality was 2.5 times lower compared to the lower one. The number of lethal outcomes in the Cyclosporin A (3 mg/kg/day) group was 3.3 times lower. A high mortality rate was observed in patients receiving thalidomide. The effectiveness of a particular method of therapy, as well as the prognosis of the disease, largely depends on the process severity, the presence and type of concomitant pathology (for example, severe course and negative outcome in patients with cancer). There is no a single point of view regarding the therapy of SSJ and TEN. Thus, a large multicenter randomized studies are crucial.