Etanercept therapy for toxic epidermal necrolysis
Etanercept therapy for toxic epidermal necrolysis
复制标题
DOI：
10.1016/j.jaad.2014.04.044
复制
发表时间：
2014-08-01
影响因子：
13.8
通讯作者：
Didona, Biagio
中科院分区：
文献类型：
--
作者：
Paradisi, Andrea;Abeni, Damiano;Didona, Biagio
背景：中毒性表皮坏死松解症(TEN)是一种严重的、潜在的致命性药物反应，目前尚无标准的治疗方法。目的：描述单剂量依那西普治疗的TEN患者的病例系列。对于每个患者，我们记录了是否存在合并症，以及最近开始使用的所有药物(即上个月)。在所有病例中，一次皮下注射50毫克依那西普。根据中毒性表皮坏死(SCORTEN)评分计算病情严重程度。使用与SCORTEN评分每一级别相关的死亡概率，我们计算了患者的预期死亡概率。愈合定义为完全再上皮化，然后用Kaplan-Meier法得出愈合时间曲线。结果：所有患者对治疗迅速起效，达到完全再上皮化，无并发症和副作用。中位治愈时间为8.5天。限制：这是一个小的、未控制的病例系列。结论：这些初步结果表明，肿瘤坏死因子-α可能是控制TEN的有效靶点，TEN是一种危险的皮肤疾病，目前还没有找到有效的治疗方法。
Background: Toxic epidermal necrolysis ( TEN) is a severe and potentially lethal drug reaction for which no standard treatment is available.Objective: To describe a case series of patients with TEN treated with a single dose of etanercept.Methods: We observed 10 consecutive patients with TEN. For each patient, we recorded the presence of comorbidities and all the drugs recently started (ie, in the last month). In all cases, 50 mg of etanercept was administered in a single subcutaneous injection. The clinical severity of disease was computed using the SCORe of Toxic Epidermal Necrosis (SCORTEN) scale. Using the probabilities of death linked to each level of SCORTEN score, we calculated the expected probability of death in our patients. Healing was defined as complete reepithelialization, and a time to healing curve was then obtained using the Kaplan-Meier method.Results: All patients promptly responded to treatment, reaching complete reepithelialization without complications or side effects. The median time to healing was 8.5 days.Limitations: This is a small, uncontrolled case series.Conclusion: These preliminary results suggest the possibility that tumor necrosis factor-alfa may be an effective target for control of TEN, a dangerous skin condition for which no effective cure has yet been found.