Publications by authors named "Thomas Bettuzzi"
Background: Epidermal necrolysis (EN) is a rare and severe condition, characterized by a diffuse skin and mucosal detachment and mainly induced by drugs. Literature is scarce regarding the rate of recurrences and culprit drug re-exposure.
Objectives: To assess the rate of EN recurrences as well as high notoriety drugs re-exposures in patients with EN.
Article Synopsis
- The study investigates the incidence and mortality rates of epidermal necrolysis (EN), including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), analyzing data from adult patients in the French Health System over nine years.
- It found an in-hospital mortality rate of 19% and a postdischarge mortality rate of 15%, leading to an overall mortality of 34% among patients.
- Key factors influencing in-hospital mortality include age, history of cancer, dementia, liver disease, and the severity of EN, with cancer and liver disease also impacting postdischarge mortality.
Article Synopsis
- - The study aimed to evaluate the effectiveness of patch tests (PTs) in identifying drugs causing non-immediate cutaneous adverse drug reactions (NICADRs) by comparing readings at days 3 (D3) and 4 (D4).
- - Findings revealed that only 13.7% of patients tested positive on D3, while 24.9% tested positive on D4, highlighting a significant increase in sensitivity with the later reading (p < 0.0001).
- - The research concluded that an additional reading at D4 improves the detection of culprit drugs in NICADRs, suggesting further investigations to confirm these results and explore the cost-effectiveness of this testing approach.
Objectives: To explore the association between industry funding and network meta-analyses' (NMAs) conclusion, and the use in Clinical Practice Guidelines (CPGs) of NMAs.
Study Design And Setting: This was an overview of NMAs and CPGs. We searched PubMed/MEDLINE, Epistemonikos, and several guideline databases up to February 18th 2023.
Article Synopsis
- Epidermal necrolysis (EN) includes severe conditions like Stevens-Johnson syndrome and is primarily drug-induced, with notable differences in incidence and outcomes between children and adults.
- A study analyzed data from the French Health System to compare EN cases in both demographics, examining incidence, suspected drug exposure, and mortality rates.
- Results showed that EN is less common in children (1.5 cases/million) compared to adults (2.6 cases/million), with children having a lower rate of drug exposure before onset and significantly lower mortality (1.4% vs. 19.4%).
Article Synopsis
- Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious skin reactions mainly triggered by drugs, with limited research on their occurrence in children.
- A study analyzed pediatric cases of SJS-TEN from the WHO VigiBase database to identify drugs associated with these reactions, covering data from 1967 to 2022.
- The research found significant signals for 165 drugs, predominantly antiepileptics and anti-infectious medications, with lamotrigine and carbamazepine being the most notable, while it ruled out vaccines as a significant risk factor.
Article Synopsis
- * A study of 120 patients showed that 36% achieved complete cutaneous remission after one year, with oral corticosteroids and a hydroxychloroquine/topical steroids combo yielding the best results.
- * The findings suggest using hydroxychloroquine and topical steroids as the best first-line treatment due to the negative side effects associated with systemic corticosteroids, with lupus pernio being a predictor of poor response.
Cutaneous adverse drug reactions (ADRs) represent a heterogeneous field including various clinical patterns without specific features suggesting drug causality. Maculopapular exanthema and urticaria are the most common types of cutaneous ADR. Serious cutaneous ADRs, which may cause permanent sequelae or have fatal outcome, may represent 2% of all cutaneous ADR and must be quickly identified to guide their management.
View Article and Find Full Text PDFBackground: Since the 2002 SCAR study, erythema multiforme (EM), a post-infectious disease, has been distinguished from Stevens-Johnson syndrome (SJS), drug-induced. Nevertheless, EM cases are still reported in the French pharmacovigilance database (FPDB).
Objectives: To describe EM reported in the FPDB and to compare the quality and the characteristics of the reports.
Objective: The worldwide coronavirus disease 2019 (COVID-19) vaccination campaign triggered several autoimmune diseases. We hereby aimed to describe IgA vasculitis (IgAV) following COVID-19 vaccination.
Methods: We conducted a national, multicenter, retrospective study in France of new-onset adult IgAV diagnosis following COVID-19 vaccination.
Article Synopsis
- Bullous pemphigoid (BP) is a common autoimmune blistering disorder with varied clinical presentations, which this study aimed to explore in detail.
- Researchers analyzed data from BP patients at two centers over a six-year period, using clustering methods to identify different profiles.
- They discovered three distinct clusters of patients, highlighting significant differences in age, clinical features, antibody presence, and severity, with one cluster related to a more severe form of the disease resembling mucous membrane pemphigoid.
Background: Possible biases in pharmacovigilance reporting may impact epidermal necrolysis (EN) and drugs associations.
Objectives: To assess biases associated with EN-reporting.
Methods: Using VigiBase, the World Health Organization-pharmacovigilance database, among drugs associated with EN between 2016 and 2020, we used an unsupervised clustering including reports characteristics, that is, reporter quality, time from drug intake to EN onset, and only one suspected drug in the report.
Background: Network meta-analyses (NMAs) have become successful in addressing gaps in the comparative effectiveness of systemic treatments in moderate-to-severe psoriasis. However, their increasing number carries both a risk of overlap and reproducibility issues that can hamper clinical decision-making.
Objectives: In this overview, we aimed to assess redundancy across these NMAs and to describe their characteristics.
Article Synopsis
- The study investigates how the availability of new systemic treatments affects drug survival in patients with moderate to severe psoriasis.
- Researchers analyzed data from 1,866 patients in a French cohort, looking specifically at those starting their first biological or synthetic disease-modifying antirheumatic drugs.
- Results showed no significant correlation between the year a patient started treatment and the effectiveness or safety of the drug, indicating that drug survival remains stable over time despite more treatment options.