The following is a summary of “APOA4 as a novel predictor of prognosis in Stevens-Johnson syndrome/toxic epidermal necrolysis: A proteomics analysis from two prospective cohorts,” published in the March 2023 issue of Dermatology by Gong, et al.
For a study, researchers sought to evaluate the efficacy and safety of combining the tumor necrosis factor-α antagonist adalimumab with conventional systemic therapies in patients with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The underlying mechanisms of action were also investigated.
Two cohorts of SJS/TEN patients were compared to assess the effectiveness and safety of the combination therapy with adalimumab. Proteomic analysis was conducted using plasma samples obtained from the patients.
The combination therapy with adalimumab significantly reduced the time required for mucocutaneous re-epithelization and healing while minimizing the side effects associated with corticosteroids. Proteomic profiling of plasma samples revealed that apolipoprotein A-IV (APOA4) exhibited notable differential expression. Multivariate regression analysis indicated a significant association between APOA4 levels and a prognostic parameter of SJS/TEN (P = .004), although no significant correlation was found with the disease severity score (severity-of-illness score for toxic epidermal necrolysis [SCORTEN]) (P = .118). Incorporating APOA4 into current SCORTEN-driven protocols could be explored for improved efficacy.
Combining adalimumab with corticosteroids provided significant clinical benefits compared to corticosteroids alone in SJS/TEN patients. Furthermore, APOA4 has the potential to serve as a novel prognostic marker for SJS/TEN. Further research was warranted to integrate APOA4 into existing SCORTEN-based protocols effectively.