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
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
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治疗方法对史蒂文斯-约翰逊综合征和中毒性表皮坏死症死亡率的影响： 对前瞻性 EuroSCAR 研究中患者的回顾性研究
DOI：
10.1016/j.jaad.2007.08.039
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发表时间：
2008-01-01
影响因子：
13.8
通讯作者：
Mockenhaupt, Maja
中科院分区：
文献类型：
--
作者：
Schneck, Juergen;Fagot, Jean-Paul;Mockenhaupt, Maja
背景：Stevens-Johnson综合征合并中毒性表皮坏死松解的治疗模式尚未确立为标准。目的：我们试图评估治疗对史蒂文斯-约翰逊综合征或中毒性表皮坏死松解症患者死亡率的影响。方法：回顾性收集法国和德国参加EuroSCAR（一项危险因素病例对照研究）的患者的治疗数据。结果：与单纯支持治疗相比，静脉注射免疫球蛋白和皮质类固醇对死亡率均无显著影响。与支持治疗相比，法国静脉注射免疫球蛋白的死亡优势比为1.4(95%可信区间：0.6-4.3)，德国为1.5(0.5-4.4)；法国皮质类固醇的死亡优势比为0.4(0.1-1-7)，德国为0.3（0.1-1.1）。局限性：这种回顾性数据收集的观察性研究有明显的局限性，包括国家之间、支持治疗、治疗剂量和持续时间的异质性。结论：我们没有发现足够的证据表明任何特定治疗有益。皮质类固醇有益作用的趋势值得进一步探讨。
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.