TY - JOUR
T1 - A new case series on etanercept treatment for toxic epidermal necrolysis
AU - Paradisi, Andrea
AU - Abeni, Damiano
AU - Didona, Dario
AU - Ricci, Francesco
AU - Canzona, Flora
AU - Didona, Biagio
N1 - Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2020/10/1
Y1 - 2020/10/1
N2 - BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe, potentially lethal drug reaction for which no standard treatment is available. OBJECTIVE: To describe 17 consecutive TEN patients treated with a single dose of etanercept, a TNF-alpha inhibitor. MATERIALS & METHODS: Comorbidities and any drug treatment initiated within the previous month were recorded on admission. Patients received 50 mg etanercept in a single subcutaneous injection. The clinical severity of the disease was computed using the SCORTEN scale. The expected number of deaths was calculated based on the probability of death associated with each SCORTEN score level. Healing was defined as complete re-epithelialization. Time to healing was analysed using the Kaplan-Meier estimator. RESULTS: The lowest SCORTEN score was 2, and seven patients scored in the most severe risk category (i.e., =>5). A comparison between observed (2/17) vs. expected deaths (10/17) was statistically significant (p=0.012). Fifteen patients promptly responded to treatment and achieved complete re-epithelization (median time to healing: 8.5 days), without complications or side effects. The two observed deaths were due to other causes, although re-epithelization had initiated in both patients. CONCLUSION: These preliminary results add to our initial observations indicating that etanercept may effectively control TEN, a potentially lethal skin condition for which there is currently no effective cure. Where funding is available, randomized controlled trials on etanercept for TEN should be conducted.
AB - BACKGROUND: Toxic epidermal necrolysis (TEN) is a severe, potentially lethal drug reaction for which no standard treatment is available. OBJECTIVE: To describe 17 consecutive TEN patients treated with a single dose of etanercept, a TNF-alpha inhibitor. MATERIALS & METHODS: Comorbidities and any drug treatment initiated within the previous month were recorded on admission. Patients received 50 mg etanercept in a single subcutaneous injection. The clinical severity of the disease was computed using the SCORTEN scale. The expected number of deaths was calculated based on the probability of death associated with each SCORTEN score level. Healing was defined as complete re-epithelialization. Time to healing was analysed using the Kaplan-Meier estimator. RESULTS: The lowest SCORTEN score was 2, and seven patients scored in the most severe risk category (i.e., =>5). A comparison between observed (2/17) vs. expected deaths (10/17) was statistically significant (p=0.012). Fifteen patients promptly responded to treatment and achieved complete re-epithelization (median time to healing: 8.5 days), without complications or side effects. The two observed deaths were due to other causes, although re-epithelization had initiated in both patients. CONCLUSION: These preliminary results add to our initial observations indicating that etanercept may effectively control TEN, a potentially lethal skin condition for which there is currently no effective cure. Where funding is available, randomized controlled trials on etanercept for TEN should be conducted.
KW - etanercept
KW - therapy
KW - toxic epidermal necrolysis (TEN)
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U2 - 10.1684/ejd.2020.3883
DO - 10.1684/ejd.2020.3883
M3 - Article
C2 - 33021477
AN - SCOPUS:85096202951
VL - 30
SP - 561
EP - 568
JO - European Journal of Dermatology
JF - European Journal of Dermatology
SN - 1167-1122
IS - 5
ER -