Proportion of Antiepileptic Drug–Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

What is the global proportion of antiepileptic drug–associated Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)? In this systematic review and meta-analysis of 50 studies including 4403 patients, 23% of SJS/TEN cases were attributed to antiepileptic drugs. Nearly all antiepileptic drug–associated cases involved aromatic agents (96%), most commonly carbamazepine (39%), phenytoin (19%), and lamotrigine (15%). These findings support the view that antiepileptic drugs are a major cause of SJS/TEN worldwide and reinforce the preferential use of nonaromatic alternatives when clinically appropriate.

Corresponding Author: Erika Yue Lee, MD, Toronto General Hospital, 200 Elizabeth St, Toronto, ON M5G 2C4, Canada (erika.lee@mail.utoronto.ca).

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