Effects of treatments on the mortality of Stevens-Johnson syndrome and toxic epidermal necrolysis: A retrospective study on patients included in the prospective EuroSCAR study

Background: No treatment modality has been established as standard for patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. Objective: We sought to evaluate the effect of treatment on mortality in a large cohort of patients with Stevens-Johnson syndrome or toxic epidermal necrolysis. Methods: Data on therapy were retrospectively collected from patients in France and Germany enrolled in EuroSCAR, a case-control study of risk factors. Results: Neither intravenous immunoglobulins nor corticosteroids showed any significant effect on mortality in comparison with Supportive care only. Compared with supportive care, odds ratios for death were 1.4 (95% confidence interval: 0.6-4.3) for intravenous immunoglobulins in France and 1.5 (0.5-4.4) in Germany, and 0.4 (0.1-1-7) for corticosteroids in France and 0.3 (0.1-1.1) in Germany. Limitations: Such an observational Study with retrospective data collection has obvious limitations, including heterogeneity between the Countries, supportive care, treatment doses, and durations. Conclusions: We found no sufficient evidence of a benefit for any specific treatment. The trend for a beneficial effect of corticosteroids deserves further exploration.