ArticleDermatology and therapy2023
Biologic TNF-α Inhibitors for Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, and TEN-SJS Overlap: A Study-Level and Patient-Level Meta-Analysis.
Article in Dermatology and therapy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Systemic Therapy for Paediatric Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Systematic Review of Current Evidence and Limitations.Journal of paediatrics and child health · 2026Pooled it
- Diagnosis and Management of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in Pediatric Patients: A Systematic Review of Clinical Guidelines and Consensus Statements.Pediatric dermatologyPooled it
- Biologics and Small Molecule Inhibitors: Novel Therapeutic Strategies for Cutaneous Adverse Drug Reactions.Drugs · 2026Review
- Immune checkpoint inhibitor-induced toxic epidermal necrolysis responding to repeated dosing of adjuvant therapy with etanercept.JAAD case reports · 2025Article
- The case for etanercept in the management of toxic epidermal necrolysis.Skin health and disease · 2025Review
- Pembrolizumab-induced toxic epidermal necrolysis with limited mucosal involvement.JAAD case reports · 2025Article
- Adalimumab combination with corticosteroid therapy for Stevens-Johnson syndrome/toxic epidermal necrolysis.Archives of dermatological research · 2025Observational
- Retrospective evaluation of a TEN/SJS series managed with a new treatment protocol.Journal of the European Academy of Dermatology and Venereology : JEADV · 2025Article
- Upadacitinib Coadministered with Methylprednisolone for Effective Treatment of SJS/TEN Overlap Syndrome: A Case Report.Clinical, cosmetic and investigational dermatology · 2025Article
- Etoricoxib and its hidden risks: a case-based review of dermatological, hematological, and cardiovascular complications.EXCLI journal · 2025Review
- Widespread rash in a 45-year-old woman after moxifloxacin administration.JAAD case reports · 2024Article
- Toxic epidermal necrolysis following heart transplantation may caused by cefoperazone sodium and sulbactam sodium.Journal of cardiothoracic surgery · 2024Article
- Article
- Severe cutaneous adverse reactions.Nature reviews. Disease primers · 2024Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionStevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions with high morbidity and mortality and not clearly established treatment protocol. This meta-analysis aimed to evaluate the efficacy and safety of three biologic TNF-α inhibitors (infliximab, etanercept, adalimumab) in the treatment of SJS, SJS-TEN overlap, and TEN.
methodsElectronic databases were searched for original studies containing human participants diagnosed with SJS/TEN and treated with biologic TNF-α inhibitors. Individual patient data were collected and summarized to provide a comprehensive overview on therapeutic efficacy of different biologic TNF-α inhibitors for SJS, SJS-TEN overlap, and TEN, respectively. Meta-analyses on aggregated study data were conducted using random-effects model.
resultsOverall, 55 studies with 125 sets of individual patient data were included. Infliximab was used to treat 3 patients with SJS-TEN overlap and 28 patients with TEN, and the actual mortality rate was 33.3% and 17%, respectively. Etanercept was administered to 17 patients with SJS, 9 patients with SJS-TEN overlap, and 64 patients with TEN, and mortality rate was reported to be 0%, 0%, and 12.5%, respectively. For participants with TEN, no significant difference was found in time of reepithelialization, hospitalization time, and mortality rate comparing etanercept with infliximab. More sequelae were reported in patients receiving infliximab than in patients treated with etanercept (39.3% versus 6.4%). Adalimumab was administered to four patients with TEN, and mortality rate was 25%. Meta-analyses on aggregated study data revealed significantly shortened hospitalization time in etanercept compared with non-etanercept groups [weighted mean differences (WMD) -5.30; 95% confidence interval (CI) -8.65 to -1.96]. Etanercept was associated with a survival benefit for patients when compared with non-etanercept treatment, however, the analysis was not statistically significant (odds ratio 0.55; 95% CI 0.23-1.33).
conclusionsOn the basis of the current findings, etanercept is currently the most promising biologic therapy for SJS/TEN. Further evaluation in prospective studies is required to confirm its efficacy and safety.
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