Etanercept Therapy for Toxic Epidermal Necrolysis?

TNF antagonist therapy is promising for TEN, but better evidence is needed.

There is no universally agreed-upon therapy for patients with toxic epidermal necrolysis (TEN). A search of the federal trials registry identified only one prospective study currently under way — an open-label pilot study of a single infusion of infliximab comparing treated patients against historical controls. A randomized trial in patients receiving thalidomide (Lancet 1999; 353:324) was aborted because treated patients had higher mortality than placebo recipients. Interest in thalidomide was generated by its effects on tumor necrosis factor α, known to be elevated in TEN. The same reasoning prompted the use of TNF antagonists. Several published reports describe etanercept or infliximab therapy in individual patients.

These authors present…

Reviewing Author

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)

Jeffrey P. Callen, MD

Disclosures

Consultant / Advisory board XOMA; Eli Lilly; Celgene

Equity Various trust accounts

Editorial boards JAMA Dermatology; UpToDate

Leadership positions in professional societies Association of Professors of Dermatology (President-Elect)