Severe cutaneous adverse drug reactions of Chinese inpatients: a meta-analysis

Abstract

BackgroundThe rate of severe cutaneous adverse drug reactions is low, and these reactions can result in death or disability. An evidence-based epidemiological study of severe cutaneous adverse drug reactions in China has not been reported.ObjectiveThe aim of this study was to analyze epidemiology and characteristics of severe cutaneous adverse drug reactions of Chinese inpatients during the recent 15 years with meta-analysis.MethodsWe retrospectively reviewed Chinese literature reporting severe cutaneous adverse drug reactions and collecting data from 2000 to 2015, which were in accordance with our inclusion criteria. All included data were analyzed with the Launch Open Meta-Analyst software.ResultsTwenty-five articles involving 928 cases with severe cutaneous adverse drug reactions were included. Men to women ratio was 1.14:1. Twenty-one per cent of the patients had drug allergy history. Antibiotics (26.0%), sedative hypnotics and anticonvulsants (21.6%), and antipyretic analgesics (17.1%) were the most common causative drugs. The most frequent clinical subtype was Stevens-Johnson syndrome (50.1%), followed by toxic epidermal necrolysis (25.4%), exfoliative dermatitis (21.0%) and drug-induced hypersensitivity syndrome (1.6%). In addition to skin rashes, patients with severe cutaneous adverse drug reactions suffered mostly from fever (73%), and blood routine abnormality (66.7%).Study limitationsThis meta-analysis is limited by its retrospective design and by its methodological variation.ConclusionThe most common causative drugs were antibiotics and sedative hypnotics and anticonvulsants. Stevens-Johnson syndrome was the most frequent clinical subtype of severe cutaneous adverse drug reactions. In addition to skin rashes, patients with severe cutaneous adverse drug reactions suffered mostly from fever, mucosal lesion, and hematologic abnormalities.

Recent developments and highlights in drug hypersensitivity

“…[6][7][8][9] Regarding SCARs, the drugs involved depend on the population (adults or children). In this sense, antibiotics and anticonvulsants are the most common ones in adults 10 ; and antibiotics, NSAIDs, and chemotherapeutics 11 as well as aromatic anticonvulsants and also allopurinol are the most frequently involved in children. [12][13][14] Over the last years, DHRs to new drugs as monoclonal antibodies, sulphasalazine and antituberculosis drugs have also been reported.…”

Amoxicillin induced erythematous maculopapular rashes: a case report

“…However, many skin diseases, it is essential to consider drugs as a possible cause of any eruption, because drug eruptions can take the form of any skin lesion. 11,12 Other than skin diseases and adverse drug reactions some systemic infections can cause skin rashes. 13 The pathophysiology of drug-induced adverse skin eruptions is not exactly known, however, immune-mediated reactions occur as a result of bizarre effects.…”

Actualización en el tratamiento de las reacciones adversas cutáneas graves a los medicamentos

“…La valoración temprana de todos los pacientes en los que se sospecha una reacción adversa a medicamento debe incluir una anamnesis completa en la que se identifiquen: posibles causas alternativas no farmacológicas, temporalidad en el desarrollo de los síntomas y datos sobre experiencias previas, dato que toma importancia al encontrarse que hasta el 25% de los pacientes que cursan con una RAM grave presenta antecedente de alergia a medicamentos (7) .…”