{"title":"抗癫痫药物使用引起的史蒂文斯-约翰逊综合征并发症的患病率：系统回顾和荟萃分析。","authors":"Samira Tardeh, Arezoo Sarmad, Masoumeh Otaghi, Fatemeh Heydari, Amir Adibi, Zahra Malekan, Reza Pakzad","doi":"10.4103/ijpvm.ijpvm_132_24","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Stevens-Johnson syndrome (SJS) as a dermatological emergency, is a severe condition with a 5% mortality rate. Antiepileptic drugs (AEDs) are linked to an increased risk of SJS, but the magnitude of this risk varies between studies, so comprehensive investigations are needed to evaluate the prevalence of SJS complications associated with AEDs.</p><p><strong>Methods: </strong>Based on PRISMA guidelines, Online databases including PubMed/Medline, CINAHL (EBSCO), Web of Science (ISI), Scopus, and Embase were searched using related MeSH-term. Studies reporting SJS as a complication of AEDs or considering AEDs suspected of inducing SJS were included. The Studies which not published in English mentioned other complications instead of skin manifestations were excluded. The data was analyzed using the STATA 14 software. To investigate heterogeneity, the Q Cochrane test and I<sup>2</sup> test were used, and the random effects model was used for combining articles.</p><p><strong>Results: </strong>Of 1630 studies, 24 studies were included in meta-analysis. The overall pooled prevalence of SJS was 23.22% (95% CI: 17.32-29.11). The pooled prevalence of SJS was 22.56% (95% CI: 16.55-28.57) in the Retrospective Cohort; 30.90% (95% CI: 5.32-56.48) in perspective Cohort, 24.84% (95% CI: 18.02-31.67) in Asia, 11.20% (95% CI: 6.10-18.4) in America, and 11.70% (95% CI: 2.77-20.63) in Europe. The I<sup>2</sup> index for the overall pooled prevalence of SJS was 93.6%. The results of the meta-regression exhibited that the sample size, publication year, age, design study, and place showed no significant effect on heterogeneity (<i>P</i> > 0.05). This review found a significant prevalence of Stevens-Johnson syndrome (SJS) linked to antiepileptic drugs (AEDs) at 23.22%.</p><p><strong>Conclusions: </strong>Clinicians should be cautious when prescribing AEDs, especially to high-risk populations. More research is needed to understand SJS mechanisms and identify genetic markers for personalized treatment approaches.</p>","PeriodicalId":14342,"journal":{"name":"International Journal of Preventive Medicine","volume":"16 ","pages":"41"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367265/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Prevalence of Stevens-Johnson Syndrome Complications due to Antiepileptic Drug Use: A Systematic Review and Meta-Analysis.\",\"authors\":\"Samira Tardeh, Arezoo Sarmad, Masoumeh Otaghi, Fatemeh Heydari, Amir Adibi, Zahra Malekan, Reza Pakzad\",\"doi\":\"10.4103/ijpvm.ijpvm_132_24\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Stevens-Johnson syndrome (SJS) as a dermatological emergency, is a severe condition with a 5% mortality rate. Antiepileptic drugs (AEDs) are linked to an increased risk of SJS, but the magnitude of this risk varies between studies, so comprehensive investigations are needed to evaluate the prevalence of SJS complications associated with AEDs.</p><p><strong>Methods: </strong>Based on PRISMA guidelines, Online databases including PubMed/Medline, CINAHL (EBSCO), Web of Science (ISI), Scopus, and Embase were searched using related MeSH-term. Studies reporting SJS as a complication of AEDs or considering AEDs suspected of inducing SJS were included. The Studies which not published in English mentioned other complications instead of skin manifestations were excluded. The data was analyzed using the STATA 14 software. To investigate heterogeneity, the Q Cochrane test and I<sup>2</sup> test were used, and the random effects model was used for combining articles.</p><p><strong>Results: </strong>Of 1630 studies, 24 studies were included in meta-analysis. The overall pooled prevalence of SJS was 23.22% (95% CI: 17.32-29.11). The pooled prevalence of SJS was 22.56% (95% CI: 16.55-28.57) in the Retrospective Cohort; 30.90% (95% CI: 5.32-56.48) in perspective Cohort, 24.84% (95% CI: 18.02-31.67) in Asia, 11.20% (95% CI: 6.10-18.4) in America, and 11.70% (95% CI: 2.77-20.63) in Europe. The I<sup>2</sup> index for the overall pooled prevalence of SJS was 93.6%. The results of the meta-regression exhibited that the sample size, publication year, age, design study, and place showed no significant effect on heterogeneity (<i>P</i> > 0.05). This review found a significant prevalence of Stevens-Johnson syndrome (SJS) linked to antiepileptic drugs (AEDs) at 23.22%.</p><p><strong>Conclusions: </strong>Clinicians should be cautious when prescribing AEDs, especially to high-risk populations. More research is needed to understand SJS mechanisms and identify genetic markers for personalized treatment approaches.</p>\",\"PeriodicalId\":14342,\"journal\":{\"name\":\"International Journal of Preventive Medicine\",\"volume\":\"16 \",\"pages\":\"41\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12367265/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Preventive Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/ijpvm.ijpvm_132_24\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Preventive Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/ijpvm.ijpvm_132_24","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
The Prevalence of Stevens-Johnson Syndrome Complications due to Antiepileptic Drug Use: A Systematic Review and Meta-Analysis.
Background: Stevens-Johnson syndrome (SJS) as a dermatological emergency, is a severe condition with a 5% mortality rate. Antiepileptic drugs (AEDs) are linked to an increased risk of SJS, but the magnitude of this risk varies between studies, so comprehensive investigations are needed to evaluate the prevalence of SJS complications associated with AEDs.
Methods: Based on PRISMA guidelines, Online databases including PubMed/Medline, CINAHL (EBSCO), Web of Science (ISI), Scopus, and Embase were searched using related MeSH-term. Studies reporting SJS as a complication of AEDs or considering AEDs suspected of inducing SJS were included. The Studies which not published in English mentioned other complications instead of skin manifestations were excluded. The data was analyzed using the STATA 14 software. To investigate heterogeneity, the Q Cochrane test and I2 test were used, and the random effects model was used for combining articles.
Results: Of 1630 studies, 24 studies were included in meta-analysis. The overall pooled prevalence of SJS was 23.22% (95% CI: 17.32-29.11). The pooled prevalence of SJS was 22.56% (95% CI: 16.55-28.57) in the Retrospective Cohort; 30.90% (95% CI: 5.32-56.48) in perspective Cohort, 24.84% (95% CI: 18.02-31.67) in Asia, 11.20% (95% CI: 6.10-18.4) in America, and 11.70% (95% CI: 2.77-20.63) in Europe. The I2 index for the overall pooled prevalence of SJS was 93.6%. The results of the meta-regression exhibited that the sample size, publication year, age, design study, and place showed no significant effect on heterogeneity (P > 0.05). This review found a significant prevalence of Stevens-Johnson syndrome (SJS) linked to antiepileptic drugs (AEDs) at 23.22%.
Conclusions: Clinicians should be cautious when prescribing AEDs, especially to high-risk populations. More research is needed to understand SJS mechanisms and identify genetic markers for personalized treatment approaches.
期刊介绍：
International Journal of Preventive Medicine, a publication of Isfahan University of Medical Sciences, is a peer-reviewed online journal with Continuous print on demand compilation of issues published. The journal’s full text is available online at http://www.ijpvmjournal.net. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal will cover technical and clinical studies related to health, ethical and social issues in field of Preventive Medicine. Articles with clinical interest and implications will be given preference.
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