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Emerging Insights into Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Induced by Immune Checkpoint Inhibitor

Min Lin1, Ting Gong2, Shifan Ruan1

  • 1Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350000, People's Republic of China.

Journal of Inflammation Research
|April 22, 2024
PubMed
Abstract

Insights

Combination therapy with adalimumab and corticosteroids significantly improves healing time and reduces mortality for severe cutaneous adverse reactions like Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) caused by anticancer drugs.

Area of Science:

  • Oncology
  • Dermatology
  • Immunology

Background:

  • Anticancer drugs can cause severe skin reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
  • The effectiveness of systemic corticosteroids for SJS/TEN is debated, prompting research into alternative treatments like TNF-alpha inhibitors.

Purpose of the Study:

  • To evaluate the efficacy and safety of combination therapy using adalimumab (a TNF-α inhibitor) for SJS/TEN induced by anticancer drugs.
  • To compare this combination therapy with corticosteroid monotherapy.

Main Methods:

  • A literature review of SJS/TEN cases (1992-2023) and analysis of patients at a specific university hospital.
  • Evaluation of clinical characteristics, healing time, mortality, and adverse events in patients treated with targeted therapies and immunotherapies.

Main Results:

  • Combination therapy with adalimumab and corticosteroids significantly reduced mucocutaneous reepithelization and healing duration compared to corticosteroid monotherapy.
  • Patients receiving adalimumab combination therapy showed lower actual mortality rates and a trend toward reduced SCORTEN-based mortality.

Conclusions:

  • Adalimumab combined with corticosteroids offers significant clinical benefits and improved safety over corticosteroids alone for SJS/TEN caused by anticancer drugs.
  • This study highlights the potential of TNF-α inhibitors as effective alternative treatments for severe cutaneous adverse reactions to cancer therapies.
Keywords:
Stevens-Johnson syndromeadalimumabanti-TNF-αtoxic epidermal necrolysistreatment

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