Survivors of Severe Drug Reactions (SJS/TEN) Face Long-Lasting Risk of Heart Disease, Stroke, and Related Deaths

* "Survivors of SJS/TEN Face a Higher Risk of Cardiovascular Diseases and Death for Years After the Acute Phase" * "Tailored Strategies Needed for Early Detection, Prevention, and Intervention to Reduce Long-Term Cardiovascular Burdens in SJS/TEN Survivors"

A nationwide study by Taiwan researchers finds that SJS/TEN survivors face a long-term risk of ischemic heart disease, stroke, and related deaths even after acute phase.

“A new nationwide study in Taiwan reveals that survivors of severe drug reactions—known as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)—face a heightened risk of heart disease and stroke long after recovery,” the researchers said in their study published in the JAMA Dermatology.

SJS/TEN cause widespread mucocutaneous blistering and epithelial sloughing, severely impact quality of life and often leave survivors with long-term health complications that remain poorly understood.

The researchers analyzed data from Taiwan’s National Health Research Institute Database linked to death records from 1998 to 2021. They compared SJS/TEN survivors to matched individuals without these conditions. 

“Compared with non-SJS/TEN participants, SJS/TEN survivors are significantly more likely to suffer from stroke (hazard ratio (HR), 1.65 [95% CI, 1.57-1.72]), ischemic heart disease (HR, 1.58 [95% CI, 1.51-1.65]), and have higher rates of death from these conditions (stroke-related death HR 1.69; heart disease-related death HR 1.55), with the greatest risk appearing about one year after the initial episode and persisting for up to 4–7 years. Notably, older patients and those who required intensive care during the acute phase are even more vulnerable,” said the study first author Hsien-Yi Chiu, an associate professor from the Department of Dermatology at National Taiwan University.  

“The present study raises awareness of the increased long-lasting risks of cardiovascular events and higher cardiovascular mortality in SJS/TEN survivors. Our results also call for more tailored monitoring and preventive strategies to minimize the higher cardiovascular mortality in SJS/TEN survivors,” he added.

 

Prof. Hsien-Yi Chiu’s email address: [email protected]

Published: 21 Mar 2025

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DOI:10.1001/jamadermatol.2024.5881

Funding information:

This work was funded in part by grants from National Taiwan University Hospital, Hsin-Chu branch (111-HCH004, 111-HCH108, 113-15 HCH013, 113-HCH106, NHRI-113-H06, 114-HCH001, HR-114-H01, 114-HCH034) and the Ministry of Science and Technology of Taiwan (MOST 110-2314-B-002-191, MOST 111-2314-B-002-244, NSTC 112-2314-B-002-073-MY3).