Cochrane · systematic review · CD013130
Systemic interventions for treatment of Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
Jacobsen, A, Olabi, B, Langley, A, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
SkinAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
50
current version
GRADE rated
6
No studies
44
Included studies
NR
No studies 44 · 88%Ungraded 0 · 0%Very low 5 · 10%Low 1 · 2%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Corticosteroids compared to no corticosteroids
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality ‐ SJS and TEN (time to Corticosteroids vs no corticosteroids | RR 2.55 [0.72, 9.03] | 2 studies · 56 participants | Very low Downgraded: risk of bias, imprecision |
Time to complete re‐epithelialisation – not reported Corticosteroids vs no corticosteroids | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Corticosteroids vs no corticosteroids | no estimate extracted | NR | No studies |
Total hospital length of stay – not reported Corticosteroids vs no corticosteroids | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJS/TEN therapy – not reported Corticosteroids vs no corticosteroids | no estimate extracted | NR | No studies |
Intravenous immunoglobulin (IVIG) compared to no IVIG
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
SJS/TEN‐specific mortality (time to Intravenous immunoglobulin (IVIG) vs no IVIG | RR 0.33 [0.04, 2.91] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Time to complete re‐epithelialisation (time to Intravenous immunoglobulin (IVIG) vs no IVIG | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Intensive care unit (ICU) length of stay ‐ not reported Intravenous immunoglobulin (IVIG) vs no IVIG | no estimate extracted | NR | No studies |
Total hospital length of stay (time to Intravenous immunoglobulin (IVIG) vs no IVIG | no estimate extracted | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects leading to discontinuation of SJS/TEN therapy ‐ not reported Intravenous immunoglobulin (IVIG) vs no IVIG | no estimate extracted | NR | No studies |
Etanercept compared to no etanercept
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality ‐ not reported Etanercept vs no etanercept | no estimate extracted | NR | No studies |
Time to complete re‐epithelialisation ‐ not reported Etanercept vs no etanercept | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Etanercept vs no etanercept | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJT/TEN therapy ‐ not reported Etanercept vs no etanercept | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Etanercept vs no etanercept | no estimate extracted | NR | No studies |
Cyclosporin compared to no cyclosporin
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality ‐ not reported Cyclosporin vs no cyclosporin | no estimate extracted | NR | No studies |
Time to complete re‐epithelialisation ‐ not reported Cyclosporin vs no cyclosporin | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Cyclosporin vs no cyclosporin | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJT/TEN therapy ‐ not reported Cyclosporin vs no cyclosporin | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Cyclosporin vs no cyclosporin | no estimate extracted | NR | No studies |
Intravenous immunoglobulin (IVIG) compared to corticosteroids
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality Intravenous immunoglobulin (IVIG) vs corticosteroids | no estimate extracted | NR | No studies |
Time to complete re‐epithelialisation ‐ not reported Intravenous immunoglobulin (IVIG) vs corticosteroids | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Intravenous immunoglobulin (IVIG) vs corticosteroids | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJT/TEN therapy ‐ not reported Intravenous immunoglobulin (IVIG) vs corticosteroids | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Intravenous immunoglobulin (IVIG) vs corticosteroids | no estimate extracted | NR | No studies |
Etanercept compared to corticosteroids
Population: treatment of Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality (time to Etanercept vs corticosteroids | RR 0.51 [0.16, 1.63] | 1 study · 91 participants | Low Downgraded: imprecision |
Time to complete re‐epithelialisation ‐ not reported Etanercept vs corticosteroids | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Etanercept vs corticosteroids | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Etanercept vs corticosteroids | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJS/TEN therapy ‐ not reported (see comments) Etanercept vs corticosteroids | no estimate extracted | NR | No studies |
Cyclosporin compared to corticosteroids
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality ‐ not reported Cyclosporin vs corticosteroids | no estimate extracted | NR | No studies |
Time to complete re‐epithelialisation ‐ not reported Cyclosporin vs corticosteroids | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Cyclosporin vs corticosteroids | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJT/TEN therapy ‐ not reported Cyclosporin vs corticosteroids | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Cyclosporin vs corticosteroids | no estimate extracted | NR | No studies |
Etanercept compared to intravenous immunoglobulin (IVIG)
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality ‐ not reported Etanercept vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Time to complete re‐epithelialisation ‐ not reported Etanercept vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Etanercept vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Etanercept vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJS/TEN therapy ‐ not reported Etanercept vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Cyclosporin compared to intravenous immunoglobulin (IVIG)
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality (time to Cyclosporin vs intravenous immunoglobulin (IVIG) | RR 0.13 [0.02, 0.98] | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision |
Time to complete re‐epithelialisation ‐ not reported Cyclosporin vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Cyclosporin vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJT/TEN therapy ‐ not reported Cyclosporin vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Cyclosporin vs intravenous immunoglobulin (IVIG) | no estimate extracted | NR | No studies |
Etanercept compared to cyclosporin
Population: Stevens‐Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐specific mortality ‐ not reported Etanercept vs cyclosporin | no estimate extracted | NR | No studies |
Time to complete re‐epithelialisation ‐ not reported Etanercept vs cyclosporin | no estimate extracted | NR | No studies |
Intensive care unit (ICU) length of stay ‐ not reported Etanercept vs cyclosporin | no estimate extracted | NR | No studies |
Total hospital length of stay ‐ not reported Etanercept vs cyclosporin | no estimate extracted | NR | No studies |
Adverse effects leading to discontinuation of SJS/TEN therapy ‐ not reported Etanercept vs cyclosporin | no estimate extracted | NR | No studies |