PMID- 27902746
OWN - NLM
STAT- MEDLINE
DCOM- 20170918
LR  - 20220317
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 11
IP  - 11
DP  - 2016
TI  - The Effect of Intravenous Immunoglobulin Combined with Corticosteroid on the 
      Progression of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 
      Meta-Analysis.
PG  - e0167120
LID - 10.1371/journal.pone.0167120 [doi]
LID - e0167120
AB  - BACKGROUND: Intravenous immunoglobulin (IVIG) treatment is commonly used to treat 
      Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) with 
      controversial therapeutic effect. METHODS: We conducted a comprehensive 
      meta-analysis through combining the published eligible studies to evaluate the 
      effectiveness of IVIG on SJS and TEN treatment. RESULTS: A total of 26 studies 
      were selected from public available databases. The combination of IVIG and 
      corticosteroid markedly reduced the recovery time (by 1.63 days, 95% CI: 
      0.83-2.43, P < 0.001), compared with solo corticosteroid group. The favorable 
      effects were greater in Asian (2.19, 95% CI: 1.41-2.97, P < 0.001), TEN (2.56, 
      95% CI: 0.35-4.77, P = 0.023) and high-dose IVIG treated individuals (1.78, 95% 
      CI: 0.42-3.14, P = 0.010). The hospitalization length reduced by 3.19 days (95% 
      CI: 0.08-6.30, P = 0.045), though the outcome was proven to be unstable. We found 
      heterogeneities, which sources were probably regional factors. Besides, IVIG was 
      inclined to decrease SJS/TEN mortality (SMR: 0.84, 95% CI: 0.66-1.08, P = 0.178). 
      This impact was possibly more profound when patients were treated with high dose 
      IVIG (SMR: 0.74, 95% CI: 0.50-1.08, P = 0.116), or when patients were diagnosed 
      as TEN (SMR: 0.68, 95% CI: 0.45-1.01, P = 0.058). CONCLUSIONS: Our current 
      meta-analysis suggests that IVIG combined with corticosteroid could reduce 
      recovery time for SJS and TEN. This effect is greater among Asian patients. 
      Whereas, its impact on reducing mortality is not significant.
FAU - Ye, Liang-Ping
AU  - Ye LP
AD  - Institute of Dermatology and Department of Dermatology at No.1 Hospital, Anhui 
      Medical University, Hefei, Anhui, China.
AD  - Physical Examination Centre, The First Affiliated Hospital of Anhui Medical 
      University, Hefei, Anhui, China.
FAU - Zhang, Cheng
AU  - Zhang C
AD  - Department of Occupational and Environmental Health, School of Public Health, 
      Anhui Medical University, Hefei, Anhui, China.
FAU - Zhu, Qi-Xing
AU  - Zhu QX
AD  - Institute of Dermatology and Department of Dermatology at No.1 Hospital, Anhui 
      Medical University, Hefei, Anhui, China.
AD  - Department of Occupational and Environmental Health, School of Public Health, 
      Anhui Medical University, Hefei, Anhui, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20161130
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Immunoglobulins, Intravenous)
SB  - IM
MH  - Adrenal Cortex Hormones/*pharmacology/therapeutic use
MH  - *Disease Progression
MH  - Drug Interactions
MH  - Humans
MH  - Immunoglobulins, Intravenous/*pharmacology/therapeutic use
MH  - Stevens-Johnson Syndrome/*drug therapy
PMC - PMC5130247
COIS- This article does not have any actual or potential conflict of interest including 
      financial, personal or other relationships with other people or organizations.
EDAT- 2016/12/03 06:00
MHDA- 2017/09/19 06:00
PMCR- 2016/11/30
CRDT- 2016/12/01 06:00
PHST- 2016/02/21 00:00 [received]
PHST- 2016/11/09 00:00 [accepted]
PHST- 2016/12/01 06:00 [entrez]
PHST- 2016/12/03 06:00 [pubmed]
PHST- 2017/09/19 06:00 [medline]
PHST- 2016/11/30 00:00 [pmc-release]
AID - PONE-D-16-04334 [pii]
AID - 10.1371/journal.pone.0167120 [doi]
PST - epublish
SO  - PLoS One. 2016 Nov 30;11(11):e0167120. doi: 10.1371/journal.pone.0167120. 
      eCollection 2016.