The Medication Risk of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis in Asians: The Major Drug Causality and Comparison With the US FDA Label
Journal
Clinical Pharmacology and Therapeutics
Journal Volume
105
Journal Issue
1
Pages
112-120
Date Issued
2019
Author(s)
Wang Y.-H.
Chen C.-B.
Tassaneeyakul W.
Saito Y.
Aihara M.
Choon S.E.
Lee H.Y.
Chang M.M.
Roa F.D.
Wu C.-W.
Zhang J.
Nakkam N.
Konyoung P.
Okamoto-Uchida Y.
Cheung C.M.-T.
Huang J.-W.
Ji C.
Cheng B.
Hui R.C.-Y.
Chen Y.-J.
Wu C.-Y.
Hsu C.-K.
Chiu T.-M.
Huang Y.-H.
Lu C.-W.
Yang C.-Y.
Lin Y.-T.
Chi M.-H.
Ho H.-C.
Lin J.-Y.
Yang C.-H.
Chang Y.-C.
Su S.-C.
Wang C.W.
Fan W.-L.
Hung S.-I.
Chung W.-H.
for the Asian Severe Cutaneous Adverse Reaction Consortium
Abstract
Specific ethnic genetic backgrounds are associated with the risk of Stevens-Johnson syndrome / toxic epidermal necrolysis (SJS/TEN) especially in Asians. However, there have been no large cohort, multiple-country epidemiological studies of medication risk related to SJS/TEN in Asian populations. Thus, we analyzed the registration databases from multiple Asian countries who were treated during 1998-2017. A total 1,028 SJS/TEN cases were identified with the algorithm of drug causality for epidermal necrolysis. Furthermore, those medications labeled by the US Food and Drug Administration (FDA) as carrying a risk of SJS/TEN were also compared with the common causes of SJS/TEN in Asian countries. Oxcarbazepine, sulfasalazine, COX-II inhibitors, and strontium ranelate were identified as new potential causes. In addition to sulfa drugs and beta-lactam antibiotics, quinolones were also a common cause. Only one acetaminophen-induced SJS was identified, while several medications (e.g., oseltamivir, terbinafine, isotretinoin, and sorafenib) labeled as carrying a risk of SJS/TEN by the FDA were not found to have caused any of the cases in the Asian countries investigated in this study.
SDGs
Publisher
Nature Publishing Group
Type
journal article