Combination of intravenous immunoglobulin and systemic corticosteroid versus corticosteroid monotherapy in Stevens-Johnson Syndrome (SJS) patients: a systematic review
Bibliographic record
Abstract
Video Abstract: https://youtu.be/qU2IS7W1tIw Background: Stevens-Johnson syndrome (SJS) is a severe, acute mucocutaneous disorder primarily triggered by medications, marked by significant morbidity and mortality. Despite improved supportive care, therapeutic management of SJS remains controversial due to inconsistent evidence regarding the optimal immunomodulatory approach. Systemic corticosteroids and intravenous immunoglobulin (IVIG) are commonly employed treatments, either individually or in combination, yet consensus on their comparative efficacy and safety is lacking. This systematic review aims to clarify the clinical effectiveness and safety of combining IVIG with systemic corticosteroids compared to corticosteroid monotherapy in patients with SJS. Methods: A systematic literature search was conducted in accordance with PRISMA guidelines, utilizing electronic databases. The databases searched included PubMed, Scopus, Google Scholar, and the Cochrane Library. Included studies are clinical trials on SJS, SJS-TEN, and TENS. All studies were evaluated using the Newcastle-Ottawa scale. Result: Of the 385 studies in the initial search, only eight cohort studies were eligible for this review, representing the analysis of 481 patients worldwide. Disease severity was primarily assessed using the SCORTEN (Severity of Illness Score for Toxic Epidermal Necrolysis) system in most studies, with mean and median SCORTEN scores ranging from 1.63 to 3. Combination therapy was associated with trends toward lower mortality, significantly faster disease resolution, and shorter hospitalisation time across multiple studies. Combination therapy arrests disease progression earlier, potentially reducing the total dose of corticosteroid needed. All studies reported adverse events and complications, including infections and IVIG-related adverse events (such as fever and chills). Conclusion: The combination of IVIg and corticosteroids may offer superior advantages in terms of increased survival benefits compared to corticosteroid monotherapy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".