title: Identification of risk factors for carbamazepine-induced serious mucocutaneous adverse reactions: A case-control study using data from spontaneous adverse drug reaction reports.
abstract: OBJECTIVE
  To identify risk factors other than genetic for severe carbamazepine-induced mucocutaneous reactions, that is, SJS, TEN, and exfoliative dermatitis (ED).
  
  
  METHODS
  We did a case-control study using data from the Swedish national database of spontaneously reported adverse drug reactions (ADRs). We selected all patients who had been reported from January 1, 1965 to March 31, 2010 as having experienced SJS (n = 78), TEN (n = 6), or ED (n = 8), and assessed as at least possibly related to carbamazepine. We also included diagnoses possibly representative of early signs of these serious conditions, that is, erythema multiforme (EM, n = 34) and scaly rash (n = 13). We compared data on demographics, drug treatment, and clinical features for these patients (cases, n = 139) with those from patients who had experienced any other type of ADR from carbamazepine during the same time period (controls, n = 887).
  
  
  RESULTS
  After adjustment for multiple comparisons, alcohol abuse was statistically significantly more common among cases than controls (34.5% vs 8.7%, odds ratio 5.5 [95% confidence interval 3.6-8.4], P = 3.14 × 10(-14) ). The same was seen for SJS and EM individually.
  
  
  CONCLUSIONS
  Alcohol abuse is a possible risk factor for serious carbamazepine-induced mucocutaneous reactions.
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Ilma
authors.initials: I
authors.lastname: Bertulyte
authors.affiliation: Uppsala Drug Information Center, Uppsala County Council, Uppsala, Sweden.
authors.forename: Sofie
authors.initials: S
authors.lastname: Schwan
authors.affiliation: Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Pär
authors.initials: P
authors.lastname: Hallberg
keywords: Alcohol; Stevens–Johnson syndrome; exfoliative dermatitis; pharmacovigilance; toxic epidermal necrolysis