{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T02:51:10Z","timestamp":1793242270041,"version":"4.5.0"},"reference-count":86,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"\n Importance<\/jats:title>\n Antiepileptic drugs (AEDs) are frequently implicated in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), which are the most severe type of drug hypersensitivity reaction, with a mortality rate up to 50%. However, the overall proportion of these cases attributed to AEDs has not been systematically reviewed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the proportion of AED-associated SJS\/TEN.<\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n The MEDLINE and Embase databases were searched from inception through March 17, 2026, with results limited to English-language publications and human participants.<\/jats:p>\n <\/jats:sec>\n \n Study Selection<\/jats:title>\n All experimental and observational studies that reported patient-level triggers of SJS\/TEN were included.<\/jats:p>\n <\/jats:sec>\n \n Data Extraction and Synthesis<\/jats:title>\n Two reviewers independently screened studies and extracted data using a predefined template. To estimate the proportion of AED-associated SJS\/TEN, a random-effects meta-analysis was performed, calculating the pooled proportions with 95% CIs. Subgroup analyses by age group (children vs adults) and geographic region were performed to explore heterogeneity.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n To estimate the proportion of AED-associated SJS\/TEN.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This systematic review and meta-analysis included 50 studies with 4403 patients that reported patient-level triggers of SJS\/TEN. Single-drug triggers accounted for 88% (95% CI, 83-92) of cases. The pooled proportion of SJS\/TEN cases attributed to AEDs was 23% (95% CI, 19-26). Nearly all AED-associated cases were due to aromatic AEDs (96%; 95% CI, 92-99), most commonly carbamazepine (39%; 95% CI, 29-50), followed by phenytoin (19%; 95% CI, 11-28), and lamotrigine (15%; 95% CI, 8-22). Nonaromatic AEDs were rarely implicated (2%; 95% CI, 0-4). Significant geographic variation was observed in the proportion of AED-associated SJS\/TEN, ranging from 42% (95% CI, 26-59) in West Asia to 10% (95% CI, 0-33) in Africa (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). The proportion of AED-associated SJS\/TEN cases was significantly higher in children (35%; 95% CI, 22-48) than in adults (23%; 95% CI, 20-27).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this systematic review and meta-analysis of observational studies, AEDs accounted for nearly one-quarter of SJS\/TEN cases reported worldwide, predominantly involving aromatic AEDs, such as carbamazepine, phenytoin, and lamotrigine. These findings suggest aromatic AEDs as leading contributors to SJS\/TEN and support the preferential use of nonaromatic AEDs when clinically appropriate.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamadermatol.2026.2473","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T15:30:35Z","timestamp":1784734235000},"page":"912","source":"Crossref","is-referenced-by-count":2,"title":["Proportion of Antiepileptic Drug\u2013Associated Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis"],"prefix":"10.1001","volume":"162","author":[{"given":"Erika Yue","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Respirology, University Health Network and Sinai Health, Toronto, Ontario, Canada"},{"name":"Drug Allergy Clinic, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, 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