APOA4 as a novel predictor of prognosis in Stevens-Johnson syndrome/toxic epidermal necrolysis: A proteomics analysis from two prospective cohorts

Gong, Ting; Zhang, Peng; Ruan, Shifan; Xiao, Zhixun; Chen, Wen; Lin, Min; Zhong, Qingmei; Luo, Renwei; Xu, Qiang; Peng, Jiamei; Cheng, Bo; Chen, Fa; Chung, Wen‐Hung; Ji, Chao

doi:10.1016/j.jaad.2023.02.058

Cited by 4 publications

(7 citation statements)

References 41 publications

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“… 102 , 103 There is a growing body of evidence supporting the use of TNF-α blockade in the treatment of patients with SJS/TEN. 8 , 104 To date, there have been several case reports as well as case-control and randomized control studies examining the use of adalimumab in the treatment of SJS/TEN. However, there has been no investigation to date that has assessed the potential advantages of a combined therapy involving anti-TNF-α agents and systemic corticosteroids for patients suffering from SJS/TEN induced by targeted anticancer therapies and immunotherapies.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with steroid monotherapy, we found that additional adalimumab to the steroid treatment could significantly reduce the time of skin healing as well as the incidence of adverse events. 8 Despite this, there is still limited knowledge on the effects of adalimumab treatment in SJS/TEN induced by targeted anticancer therapies and immunotherapies patients.…”

Section: Discussionmentioning

confidence: 99%

“…These results contribute to the growing body of evidence supporting the efficacy of TNF-α inhibitors in this context. 8 …”

Section: Introductionmentioning

confidence: 99%

“…However, they can result in substantial mortality and severe long-term effects, significantly reducing the quality of life for affected patients. [4][5][6][7][8][9] While the precise biological mechanisms driving SJS/TEN remain incompletely understood, this process may entail the hyperactivation of CD8 + cytotoxic T lymphocytes and the ensuing occurrence of cytokine storms. 10,11 Elevated concentrations of granulysin, a cytolytic protein, and tumor necrosis factor (TNF)-α, an inflammatory cytokine, are detectable in the plasma and blister fluids of afflicted individuals.…”

Section: Introductionmentioning

confidence: 99%

“…These results contribute to the growing body of evidence supporting the efficacy of TNF-α inhibitors in this context. 8 The progress made in cancer detection and the evolution of anticancer drug therapy have contributed to a rising occurrence of cutaneous adverse reactions following the administration of anticancer medications. 20 Patients afflicted with malignancies commonly present with concurrent comorbidities, multi-systemic involvement, and are subjected to multiple concomitant medications and treatment modalities.…”

Section: Introductionmentioning

confidence: 99%

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

Lin,

Gong,

Ruan

et al. 2024

JIR

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Objective Anticancer drugs have revolutionized tumor therapy, with cutaneous toxicities such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) being common immune-related adverse events. The debate over the efficacy of systemic corticosteroids in treating these conditions persists, while tumor necrosis factor (TNF)-alpha inhibitors show promise. This study aims to evaluate the effectiveness and safety of combination therapy involving the TNF-α inhibitor adalimumab for SJS/TEN induced by anticancer drugs. Methods A literature review of SJS/TEN cases induced by anticancer drugs from 1992 to 2023 was conducted, alongside an analysis of patients admitted to the First Affiliated Hospital of Fujian Medical University during the same period. Clinical characteristics, skin healing time, mortality, and adverse events were evaluated in two treatment groups: SJS/TEN patients treated with targeted anticancer therapies and immunotherapies. Results Among the 27 patients studied (18 with SJS or SJS-TEN overlapping and 9 with TEN), combination therapy with adalimumab significantly reduced mucocutaneous reepithelization time and healing duration compared to corticosteroid monotherapy. Patients receiving adalimumab combined with corticosteroids had lower actual mortality rates than those on corticosteroid monotherapy. The combination therapy also showed a trend towards reducing standardized mortality rates based on the Score of Toxic Epidermal Necrolysis (SCORTEN). Conclusion The findings suggest that adalimumab in combination with corticosteroids provides significant clinical benefits and is safer than corticosteroids alone for treating SJS/TEN induced by targeted anticancer therapies and immunotherapies. This study contributes valuable insights into potential treatment strategies for severe cutaneous adverse reactions to anticancer drugs, highlighting the importance of exploring alternative therapies such as TNF-α inhibitors in managing these conditions effectively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…These results contribute to the growing body of evidence supporting the efficacy of TNF-α inhibitors in this context. 8 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Lin,

Gong,

Ruan

et al. 2024

JIR

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Severe cutaneous adverse reactions

Hung,

Mockenhaupt,

Blumenthal

et al. 2024

Nat Rev Dis Primers

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Ocular involvement in Steven-Johnson syndrome/toxic epidermal necrolysis: recent insights into pathophysiology, biomarkers, and therapeutic strategies

Pisitpayat,

Nijvipakul,

Jongkhajornpong

2024

Current Opinion in Ophthalmology

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Purpose of review To review the pathophysiology, recent biomarkers related to the ocular aspects of Steven-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), and to highlight notable evidence published in recent years. Recent findings Several studies reveal the relationship between tear cytokines and the pathological components in eyes of SJS/TEN patients. Specific clinical features and associated risk factors in the acute stage have shown significant correlations with chronic ocular sequelae. Recent treatment protocols, including early pulse systemic and topical steroids, as well as tumor necrosis factor-α inhibitors, have demonstrated positive effects on ocular outcomes. In addition to conventional surgical treatment, a new surgical technique, simple oral mucosal epithelial transplantation (SOMET), has been introduced as a simple ocular surface reconstruction for patient with SJS. Summary Advancements in knowledge and management strategies have notably enhanced ocular outcomes for SJS/TEN eyes. A deeper understanding of the biomarker changes in these eyes could facilitate the development of future targeted treatment options.

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APOA4 as a novel predictor of prognosis in Stevens-Johnson syndrome/toxic epidermal necrolysis: A proteomics analysis from two prospective cohorts

Cited by 4 publications

References 41 publications

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

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

Severe cutaneous adverse reactions

Ocular involvement in Steven-Johnson syndrome/toxic epidermal necrolysis: recent insights into pathophysiology, biomarkers, and therapeutic strategies

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