Evaluation of the Effectiveness of Therapy for Stevens−Johnson Syndrome and Toxic Epidermal Necrolysis: A Review

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Abstract


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.


Anfisa A. Lepekhova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: anfisa.lepehova@yandex.ru

Russian Federation

MD, PhD, Associate professor.

Moscow.

SPIN-код: 3261-3520

Anastasiya S. Allenova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: erika-mma@yandex.ru
ORCID iD: 0000-0003-0751-0073

Russian Federation

MD, PhD, assistant researcher.

Moscow.

SPIN-код: 7765-7631

Olga Yu. Olisova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: olisovaolga@mail.ru
ORCID iD: 0000-0003-2482-1754

Russian Federation

MD, PhD, professor.

Moscow.

SPIN-код: 2500-7989

Nataliya P. Teplyuk

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: Teplyukn@gmail.ru
ORCID iD: 0000-0002-5800-4800

Russian Federation

MD, PhD, professor.

Moscow.

SPIN-код: 8013-3256

Elizaveta V. Kanareikina

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: liza.kanareikina@mail.ru
ORCID iD: 0000-0001-5846-8712

Russian Federation

Moscow.

SPIN-код: 8964-2703

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