The effectiveness of systemic steroid therapy for Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) has been questioned. It was unknown if further tumor necrosis factor (TNF)-α inhibition provides an optimum method. For a study, researchers sought to determine the effectiveness of TNF-α inhibition in combination with a steroid in the treatment of SJS/TEN and to discover relevant biomarkers.

About 25 SJS/TEN patients were recruited and split into two groups: 10 got methylprednisolone, and 15 received etanercept + methylprednisolone. Multiplex cytokine analysis kits were used to evaluate serum levels of granzyme B, perforin, interferon-γ, interleukin (IL) 6, IL-15, IL-18, macrophage inflammatory protein 1α, and 1β, and TNF-α throughout the acute and resolution phases.

When compared to steroid monotherapy, combined therapy dramatically reduced the length of the first steroid treatment as well as the acute stage, hospitalized stay, and skin re-epithelialization. Although both medications lowered IL-15 levels considerably, the combination therapy also reduced IL-6 and IL-18 levels. While IL-15 levels were favorably connected with skin re-epithelialization time in both groups, IL-6 levels functioned as an additional indication for disease progression in the combination treatment group.

Reference: jaad.org/article/S0190-9622(22)00171-2/fulltext