{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:14:56Z","timestamp":1791357296421,"version":"4.3.1"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T00:00:00Z","timestamp":1507852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008375","name":"Universit\u00e4t Basel","doi-asserted-by":"publisher","award":["DMS2297"],"award-info":[{"award-number":["DMS2297"]}],"id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2017,12]]},"abstract":"Summary<\/jats:title>\n \n Objective<\/jats:title>\n \n Older antiepileptic drugs (\n AEDs<\/jats:styled-content>\n ) are known to cause Stevens\u2010Johnson syndrome and toxic epidermal necrolysis (\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n ). However, evidence for newer\n AED<\/jats:styled-content>\n is sparse. We quantified risks of\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n in association with use of all\n AED<\/jats:styled-content>\n s in the United Kingdom.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In a matched case\u2010control study of 480 previously validated\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n cases (1995\u20132013) we used conditional logistic regression to calculate odds ratios (\n ORs<\/jats:styled-content>\n ) with 95% confidence intervals (\n CIs<\/jats:styled-content>\n ), and calculated absolute risks of\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n within separate cohorts of new users of 28\n AED<\/jats:styled-content>\n s. We assessed causality between drugs and\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n in each exposed case, using an adapted version of the algorithm of drug causality for epidermal necrolysis (\n ALDEN<\/jats:styled-content>\n ) score.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We observed a strong association between\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n and new use of carbamazepine (\n OR<\/jats:styled-content>\n 92.57, 95%\n CI<\/jats:styled-content>\n 19.89\u2013\u221e), phenytoin (\n OR<\/jats:styled-content>\n 49.96, 95%\n CI<\/jats:styled-content>\n 10.13\u2013\u221e), and lamotrigine (\n OR<\/jats:styled-content>\n 26.90, 95%\n CI<\/jats:styled-content>\n 4.88\u2013\u221e), where causality, according to the\n ALDEN<\/jats:styled-content>\n score, was very probable or probable for most exposed cases. Absolute risks for\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n were highest for phenytoin (45.86 cases\/100,000 exposed), lamotrigine (44.17 cases\/100,000 exposed), and carbamazepine (20.38 cases\/100,000 exposed). Despite increased\n OR<\/jats:styled-content>\n s for valproate (40,941 exposed), gabapentin (116,037 exposed), pregabalin (59,967 exposed), and clobazam (4,300 exposed),\n ALDEN<\/jats:styled-content>\n suggested no causal association. There were no observed cases of\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n among new users of levetiracetam (n\u00a0=\u00a096,77), clonazepam (n\u00a0=\u00a018,075), or topiramate (n\u00a0=\u00a011,307).\n <\/jats:p>\n <\/jats:sec>\n \n Significance<\/jats:title>\n \n The results of our study are consistent with those of previous studies of\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n , which found increased risks of\n SJS<\/jats:styled-content>\n \/\n TEN<\/jats:styled-content>\n in new use of carbamazepine, phenytoin, and lamotrigine. Despite frequent use, no\n ALDEN<\/jats:styled-content>\n \u2010score confirmed cases were observed in new users of valproate, gabapentin, pregabalin, levetiracetam, topiramate, or clonazepam.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/epi.13925","type":"journal-article","created":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T02:07:01Z","timestamp":1507860421000},"page":"2178-2185","source":"Crossref","is-referenced-by-count":64,"title":["The risk of Stevens\u2010Johnson syndrome and toxic epidermal necrolysis in new users of antiepileptic drugs"],"prefix":"10.1111","volume":"58","author":[{"given":"Noel","family":"Frey","sequence":"first","affiliation":[{"name":"Basel Pharmacoepidemiology Unit Division of Clinical Pharmacy and Epidemiology Department of Pharmaceutical Sciences University of Basel Basel Switzerland"},{"name":"Hospital Pharmacy University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bodmer","sequence":"additional","affiliation":[{"name":"Internal Medicine Cantonal Hospital Zug Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Bircher","sequence":"additional","affiliation":[{"name":"Allergology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"R\u00fcegg","sequence":"additional","affiliation":[{"name":"Division of Clinical Neurophysiology University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan S.","family":"Jick","sequence":"additional","affiliation":[{"name":"Boston Collaborative Drug Surveillance Program Boston University Lexington Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph R.","family":"Meier","sequence":"additional","affiliation":[{"name":"Basel Pharmacoepidemiology Unit Division of Clinical Pharmacy and Epidemiology Department of Pharmaceutical Sciences University of Basel Basel Switzerland"},{"name":"Hospital Pharmacy University Hospital Basel Basel Switzerland"},{"name":"Boston Collaborative Drug Surveillance Program Boston University Lexington Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Spoendlin","sequence":"additional","affiliation":[{"name":"Basel Pharmacoepidemiology Unit Division of Clinical Pharmacy and Epidemiology Department of Pharmaceutical Sciences University of Basel Basel Switzerland"},{"name":"Hospital Pharmacy University Hospital Basel Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31821201ed"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000335627"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/ddg.12747","article-title":"Severe drug\u2010induced skin reactions: clinical features, diagnosis, etiology, and therapy","volume":"13","author":"Paulmann M","year":"2015","journal-title":"J Dtsch Dermatol Ges"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jid.5701033"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332404"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)05418-X"},{"key":"e_1_2_9_8_1","first-page":"2732","article-title":"Spontaneous reporting of Stevens\u2010Johnson syndrome and toxic 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