title: [Is intravenous immunoglobulin effective in toxic epidermal necrolysis and Stevens-Johnson syndrome?].
abstract: Toxic epidermal necrolysis and Stevens-Johnson syndrome are severe cutaneous adverse drug reactions. Intravenous immunoglobulin is described as a therapeutic option, however its use is still controversial. Using Epistemonikos database, which is maintained by screening over 20 databases, we identified six systematic reviews, including 39 primary studies. We combined the evidence using tables for summary of findings, following the GRADE approach, and concluded there is uncertainty about the effects of intravenous immunoglobulin because the certainty of the evidence is very low; it probably leads to important adverse effects; and has high cost. Intravenous immunoglobulin should not be used outside the context of a clinical trial, or only in cases where other treatments have failed and there are no resource constraints.
authors.affiliation: Escuela de Medicina, Pontificia Universidad Católica de Chile; Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile. Address: Facultad de Medicina Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile. Email: radagabriel@epistemonikos.org.
authors.forename: Lucas
authors.initials: L
authors.lastname: Navajas
authors.affiliation: Escuela de Medicina, Pontificia Universidad Católica de Chile; Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile; GRADE Working Group; The Cochrane Collaboration; Fundación Epistemonikos.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rada
mesh_terms: D016527:Drug Costs; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors