Effects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective study on patients included in the prospective EuroSCAR Study

J Am Acad Dermatol. 2008 Jan;58(1):33-40. doi: 10.1016/j.jaad.2007.08.039. Epub 2007 Oct 4.

Abstract

Background: No treatment modality has been established as standard for patients with Stevens-Johnson syndrome and toxic epidermal necrolysis.

Objective: We sought to evaluate the effect of treatment on mortality in a large cohort of patients with Stevens-Johnson syndrome or toxic epidermal necrolysis.

Methods: Data on therapy were retrospectively collected from patients in France and Germany enrolled in EuroSCAR, a case-control study of risk factors.

Results: Neither intravenous immunoglobulins nor corticosteroids showed any significant effect on mortality in comparison with supportive care only. Compared with supportive care, odds ratios for death were 1.4 (95% confidence interval: 0.6-4.3) for intravenous immunoglobulins in France and 1.5 (0.5-4.4) in Germany, and 0.4 (0.1-1.7) for corticosteroids in France and 0.3 (0.1-1.1) in Germany.

Limitations: Such an observational study with retrospective data collection has obvious limitations, including heterogeneity between the countries, supportive care, treatment doses, and durations.

Conclusions: We found no sufficient evidence of a benefit for any specific treatment. The trend for a beneficial effect of corticosteroids deserves further exploration.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Aged
  • Case-Control Studies
  • Cohort Studies
  • Female
  • France
  • Germany
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Retrospective Studies
  • Stevens-Johnson Syndrome / drug therapy*
  • Stevens-Johnson Syndrome / mortality*

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulins, Intravenous