630 A multicenter single-arm study of etanercept treatment in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) and biomarkers of systemic steroid therapy resistance

Etanercept, a TNF-α inhibitor, has been reported to be effective in SJS/TEN and is considered new treatment option. We conducted study evaluate the safety efficacy of etanercept patients who do not respond well steroid therapy. Four cases with no response for therapy (PSL 20 mg/day or more) enrolled this study. Etanercept was administered subcutaneously (50 mg) once week while continued. Although mean SCORTEN, predictive score mortality, 2.0, indicating predicted mortality 12.1%, an observed 0%. The median time re-epithelialization 18.5 days end skin symptom progression 3.5 days. There one adverse event: patient developed sepsis that cured treatment. investigated potential biomarkers by comparing improved (n=14) those did (n=8). Patients’ refractory were efficiently complicated malignancy (62.5%) diabetes (25%). Remarkably, all these malignancies treated immune checkpoint inhibitors. measured multiple cytokines (n=19) serum Bio-Rad 48-Plex Screening Panel. Compared erythema multiforme (n=7) healthy controls (n=15), significantly higher acute (P<0.05, P<0.001, respectively). When compared before after therapy, had significant decrease (P<0.05). On other hand, there difference therapy-refractory cases, three elevated TNF-α. Steroid resistance suggests poorly reduced may both therapeutic target biomarker resistance.