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- Presentation
Etanercept Therapy for Toxic Epidermal Necrolysis
Description
The presentation discusses a study on the effectiveness of etanercept in treating Toxic Epidermal Necrolysis (TEN), a severe drug-induced skin reaction with high mortality rates and no established standard therapy. The study involved ten patients diagnosed with TEN, with varying severities of the disease and notable comorbidities. The suspected drugs causing TEN, particularly carbamazepine, were promptly ceased upon diagnosis. Patients were treated with a single subcutaneous injection of 50 mg of etanercept, administered within six hours of hospitalization. Remarkably, all patients showed a positive response to the treatment, achieving complete reepithelialization within a median of 8.5 days and without complications or side effects. Despite the expected mortality risk of 46.9%, no deaths occurred in this cohort. The mechanism of etanercept is to inhibit TNF-alpha, a factor associated with the pathogenesis of TEN. The results indicate that etanercept is a safe and effective treatment, warranting consideration as a viable therapeutic option for TEN. The study also incorporates findings from a larger cohort of 271 patients, further substantiating the survival benefits of etanercept therapy.
View moreConclusions
- Toxic epidermal necrolysis (TEN) is a serious drug-induced condition with high mortality and no effective standard treatment.
- Etanercept, a TNF-alpha antagonist, was evaluated for its safety and efficacy in ten patients with TEN.
- All ten patients received a single subcutaneous dose of 50 mg of etanercept, administered within six hours of hospitalization.
- Every patient responded positively to etanercept, achieving complete re-epithelialization without complications.
- The median time to healing for the patients was 8.5 days, with a range of 7 to 20 days.
- The expected mortality based on the SCORTEN score was calculated to be 46.9%, but no deaths occurred in the treated patients.
- The study suggests that etanercept can be considered an effective and safe treatment option for TEN, with advantages such as rapid action and manageability.
- The results support etanercept as a potential new therapeutic approach for TEN, validating its effectiveness through observed survival rates compared to predicted mortality.
- Bastuji-Garin S et al. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol 2000; 115: 149.
- Paradisi A, Abeni D, Bergamo F, Ricci F, Didona D, Didona B. Etanercept therapy for toxic epidermal necrolysis. J Am Acad Dermatol 2014.
- Paradisi A, Abeni D, Didona D, Ricci F, Canzona F, Didona B. A new case series on etanercept treatment for toxic epidermal necrolysis. Eur J Dermatol 2020.