계명대학교 의학도서관 Repository

Severe Cutaneous Adverse Reactions to Antiepileptic Drugs: A Nationwide Registry-Based Study in Korea

Metadata Downloads
Author(s)
Chan Sun ParkDong Yoon KangMin Gyu KangSujeong KimYoung Min YeSae Hoon KimHye-Kyung ParkJung-Won ParkYoung Hee NamMin-Suk YangYoung-Koo JeeJae Woo JungSang Hyon KimCheol-Woo KimMi-Yeong KimJoo Hee KimJaechun LeeJun-Gyu LeeSang Hyun KimHyen O LaMin-Hye KimSeoung Ju ParkYoung-Il KohSang-Min LeeYong Eun KwonHyun Jung JinHee-Kyoo KimHye-Ryun KangJeong-Hee Choi
Keimyung Author(s)
Kim, Sang Hyon
Department
Dept. of Internal Medicine (내과학)
Journal Title
Allergy, Asthma & Immunology Research
Issued Date
2019
Volume
11
Issue
5
Keyword
Antiepileptic drugsStevens-Johnson syndrometoxic epidermal necrolysis
Abstract
Purpose:
Severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) to antiepileptic drug (AED), are rare, but result in significant morbidity and mortality. We investigated the major culprit drugs, clinical characteristics, and clinical course and outcomes of AED-induced SCARs using a nationwide registry in Korea.

Methods:
A total of 161 patients with AED-induced SCARs from 28 referral hospitals were analyzed. The causative AEDs, clinical characteristics, organ involvements, details of treatment, and outcomes were evaluated. We compared the clinical and laboratory parameters between SJS/TEN and DRESS according to the leading causative drugs. We further determined risk factors for prolonged hospitalization in AED-induced SCARs.

Results:
Carbamazepine and lamotrigine were the most common culprit drugs causing SCARs. Valproic acid and levetiracetam also emerged as the major causative agents. The disease duration and hospital stay in carbamazepine-induced SJS/TEN were shorter than those in other AEDs (P< 0.05, respectively). In younger patients, lamotrigine caused higher incidences of DRESS than other drugs (P= 0.045). Carbamazepine, the most common culprit drug for SCARs, was associated with a favorable outcome related with prolonged hospitalization in SJS (odds ratio, 0.12; 95% confidence interval, 0.02-0.63, P= 0.12), and thrombocytopenia was found to be a risk factor for prolonged hospitalization in DRESS.

Conclusion:
This was the first large-scale epidemiological study of AED-induced SCARs in Korea. Valproic acid and levetiracetam were the significant emerging AEDs causing SCARs in addition to the well-known offending AEDs such as carbamazepine and lamotrigine. Carbamazepine was associated with reduced hospitalization, but thrombocytopenia was a risk factor for prolonged hospitalization. Our results suggest that the clinical characteristics and clinical courses of AED-induced SCARs might vary according to the individual AEDs.
Keimyung Author(s)(Kor)
김상현
Publisher
School of Medicine (의과대학)
Citation
Chan Sun Park et al. (2019). Severe Cutaneous Adverse Reactions to Antiepileptic Drugs: A Nationwide Registry-Based Study in Korea. Allergy, Asthma & Immunology Research, 11(5), 709–722. doi: 10.4168/aair.2019.11.5.709
Type
Article
ISSN
2092-7363
Source
https://e-aair.org/DOIx.php?id=10.4168/aair.2019.11.5.709#
DOI
10.4168/aair.2019.11.5.709
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/42302
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
공개 및 라이선스
  • 공개 구분공개
파일 목록

Items in Repository are protected by copyright, with all rights reserved, unless otherwise indicated.