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The Epidemiology of Stevnes-Johnson Syndrome and Toxic Epidermal Necrolysis in the UK

Frey, Noel and Jossy, Janine and Bodmer, Michael and Jick, Susan S. and Meier, Christoph R. and Spoendlin, Julia. (2017) The Epidemiology of Stevnes-Johnson Syndrome and Toxic Epidermal Necrolysis in the UK. Journal of Investigative Dermatology, 137. pp. 1240-1247.

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Official URL: http://edoc.unibas.ch/59031/

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Abstract

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening mucocutaneous diseases. SJS/TEN mostly manifest as a reaction to new drug use, but little is known about their incidence and epidemiology. We conducted a large observational study on the epidemiology of SJS/TEN using data from the UK-based Clinical Practice Research Datalink. Among 551 validated SJS/TEN patients, we calculated an incidence rate of 5.76 SJS/TEN cases per million person-years between 1995 and 2013, which was consistent throughout the study period and was highest in patients aged 1e10 years and 80 years or older. Within a 1:4 matched case-control analysis, black and Asian patients were at a 2-fold risk of SJS/TEN when compared with white patients. Among patients with epilepsy and gout, odds ratios for SJS/TEN were significantly increased only in the presence of recent new drug treatment with antiepileptics or allopurinol, respectively. We observed statistically significant associations between SJS/TEN and pre-existing depression, lupus erythematosus, recent pneumonia, chronic kidney disease, and active cancer, but confounding by drug use needs to be followed up. This large and longitudinal observational study on the epidemiology of SJS/TEN contributes to the understanding of this still underinvestigated severe skin disease in a European and largely white study population. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but life-threatening mucocutaneousdiseases. SJS/TEN mostly manifest as a reaction to new drug use, but little is known about their incidenceand epidemiology. We conducted a large observational study on the epidemiology of SJS/TEN using datafrom the UK-based Clinical Practice Research Datalink. Among 551 validated SJS/TEN patients, we calculated anincidence rate of 5.76 SJS/TEN cases per million person-years between 1995 and 2013, which was consistentthroughout the study period and was highest in patients aged 1e10 years and 80 years or older. Within a 1:4matched case-control analysis, black and Asian patients were at a 2-fold risk of SJS/TEN when compared withwhite patients. Among patients with epilepsy and gout, odds ratios for SJS/TEN were significantly increased onlyin the presence of recent new drug treatment with antiepileptics or allopurinol, respectively. We observedstatistically significant associations between SJS/TEN and pre-existing depression, lupus erythematosus, recentpneumonia, chronic kidney disease, and active cancer, but confounding by drug use needs to be followed up.This large and longitudinal observational study on the epidemiology of SJS/TEN contributes to the understandingof this still underinvestigated severe skin disease in a European and largely white study population.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Spital-Pharmazie > Spitalpharmazie (Meier)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Spital-Pharmazie > Spitalpharmazie (Meier)
UniBasel Contributors:Frey, Noel and Meier, Christoph R. and Bircher, Andreas J.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0022-202X
e-ISSN:1523-1747
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:13 Jul 2020 14:31
Deposited On:13 Jul 2020 14:31

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