원문정보
초록
영어
Background: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immune-complex-mediatedhypersensitivity reactions that predominantly involve skin and mucous membranes. Despite the low incidence, both areconsidered medical emergencies as the mortality rate has been estimated at 30-50%. Although as many as half of casesare idiopathic, several drugs have been implicated as main cause of SJS/TEN. This review therefore aimed to identifydrugs that were potentially associated with SJS/TEN and compare the relative risk of the medications. Method: A comprehensivesearch was performed using MEDLINE, EMBASE and 5 Korean databases. We defined study drugs as nonsteroidalanti- inflammatory drugs (NSAIDs), antibiotics, antiepileptics, and allopurinol. Only epidemiologic studiesinvestigating associations between the above drugs and drug-induced SJS/TEN were included. Two reviewers independentlyselected and evaluated candidate papers and extracted odds ratios or incidence rates. Meta-analysis was performedonly for drugs that were reported from 4 or more studies. Results: We found 8 case-control studies, 3 cohortstudies and 1 RCT. The ranges of adjusted ORs were 0.6-34.0 for NSAIDs, 1.6-302.0 for antiepileptics, 0.3- 10.0 forantibiotics and 1.0-187.0 for allopurinol. The drug with the highest incidence of SJS/TEN was carbamazepine (40 persons/1,000 DDD). Conclusion: Finally, the risk was highest in first 8 weeks after onset of treatment in all drugs.
목차
연구방법
핵심질문 선정 및 문헌검색
문헌 선정
자료 추출 및 질평가
자료 분석 및 결과제시
연구결과
문헌검색 및 선정
선정된 문헌의 개요 및 질평가 결과
환자-대조군연구에서 보고된 약물별 위험도
코호트연구 및 무작위배정비교임상시험
고찰 및 결론
참고문헌
Appendix