TY - JOUR
T1 - Clinical Profiles of Japanese Patients with Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis Collected by a Nationwide System from 2006 to 2023
AU - Tsukagoshi, Eri
AU - Nakamura, Ryosuke
AU - Kaniwa, Nahoko
AU - Sai, Kimie
AU - Kikura-Hanajiri, Ruri
AU - Matsunaga, Kayoko
AU - Abe, Riichiro
AU - Asada, Hideo
AU - Saito, Yoshiro
N1 - Publisher Copyright:
© 2024 The Pharmaceutical Society of Japan.
PY - 2024
Y1 - 2024
N2 - Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially life-threatening severe cutaneous adverse drug reactions. These diseases are rare, and their onset is difficult to predict because of their idiosyncratic reactivity. The Japan Severe Adverse Reactions Research Group, led by the National Institute of Health Sciences, has operated a nationwide to collect clinical information and genomic samples from patients with SJS/TEN since 2006. This study evaluated the associations of clinical symptoms with sequelae and specific causative drugs/drug groups in Japanese patients with SJS/TEN to identify clinical clues for SJS/TEN treatment and prognosis. Acetaminophen, antibiotics, and carbocisteine were linked to high frequencies of severe ocular symptoms and ocular sequelae (p<0.05). For erythema and erosion areas, antipyretic analgesics had higher rates of skin symptom affecting <10% of the skin than the other drugs, suggesting narrower lesions (p<0.004). Hepatic dysfunction, was common in both SJS and TEN, and antiepileptic drugs carried higher risks of hepatic dysfunction than the other drug groups (p=0.0032). This study revealed that the clinical manifestations of SJS/TEN vary according to the causative drugs.
AB - Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially life-threatening severe cutaneous adverse drug reactions. These diseases are rare, and their onset is difficult to predict because of their idiosyncratic reactivity. The Japan Severe Adverse Reactions Research Group, led by the National Institute of Health Sciences, has operated a nationwide to collect clinical information and genomic samples from patients with SJS/TEN since 2006. This study evaluated the associations of clinical symptoms with sequelae and specific causative drugs/drug groups in Japanese patients with SJS/TEN to identify clinical clues for SJS/TEN treatment and prognosis. Acetaminophen, antibiotics, and carbocisteine were linked to high frequencies of severe ocular symptoms and ocular sequelae (p<0.05). For erythema and erosion areas, antipyretic analgesics had higher rates of skin symptom affecting <10% of the skin than the other drugs, suggesting narrower lesions (p<0.004). Hepatic dysfunction, was common in both SJS and TEN, and antiepileptic drugs carried higher risks of hepatic dysfunction than the other drug groups (p=0.0032). This study revealed that the clinical manifestations of SJS/TEN vary according to the causative drugs.
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U2 - 10.1248/bpb.b23-00595
DO - 10.1248/bpb.b23-00595
M3 - Article
C2 - 38171782
AN - SCOPUS:85181628225
SN - 0918-6158
VL - 47
SP - 88
EP - 97
JO - Biological and Pharmaceutical Bulletin
JF - Biological and Pharmaceutical Bulletin
IS - 1
ER -