Lamotrigine-induced severe cutaneous adverse reaction: Update data from 1999-2014.
We systematically reviewed and analyzed published patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) associated with lamotrigine therapy to identify characteristics of these reactions. We identified a total of 70 patients (42 SJS, five SJS/TEN, 23 TEN). The female to male ratio was 2.83:1 in the TEN group and 1.47:1 in the SJS group. Patients in the TEN group were younger than in the SJS group but this difference was not significant (28.35 versus 32.71 years, respectively; p=0.27). The median time to onset was 25.33 versus 18.42 days for SJS and TEN, respectively. The median dosage at onset was 36.46 versus 57.29mg, and final dosage 111.25 versus 97.92mg/day for SJS and TEN, respectively. The median final dosages did not significantly differ. Concomitant use of valproate acid was reported in 54.55% of the SJS patients and 50.00% of the TEN patients. Three fatal reactions were reported, of which two patients deteriorated rapidly and died within 12h of admission, indicating that this disease can develop rapidly before effective treatment. There was no significant difference between the SJS and TEN groups in any of the clinical factors examined which confirmed the opinion that SJS and TEN are part of a single disease spectrum.
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China. Electronic address: bjxqwang13@163.com.
Xiang-qing
XQ
Wang
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Bin
B
Lv
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Hong-fen
HF
Wang
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Xu
X
Zhang
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Sheng-yuan
SY
Yu
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Xu-sheng
XS
Huang
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Jia-tang
JT
Zhang
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Cheng-lin
CL
Tian
Department of Neurology, The Chinese People's Liberation Army General Hospital, 28 Fuxing Road, Beijing 100853, China.
Sen-yang
SY
Lang
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D013262:Stevens-Johnson Syndrome / Q000453:epidemiology* / Q000209:etiology*; D014227:Triazines / Q000008:administration & dosage / Q000009:adverse effects*; D014635:Valproic Acid / Q000009:adverse effects
D000927:Anticonvulsants; D014227:Triazines; D014635:Valproic Acid; D000077213:Lamotrigine
Antiepileptic drugs; Lamotrigine; Stevens–Johnson syndrome; Toxic epidermal necrolysis