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SYSTEMATIC REVIEW article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1490334

Fatal outcome related to drug reaction with eosinophilia and systemic symptoms (DRESS): a disproportionality analysis of FAERS database and a systematic review of cases

Provisionally accepted
Chun-su Liang Chun-su Liang Peng-jiao An Peng-jiao An Yi-zhou Zhang Yi-zhou Zhang Xin Liu Xin Liu *Bo Zhang Bo Zhang
  • Peking Union Medical College Hospital (CAMS), Beijing, China

The final, formatted version of the article will be published soon.

    Background: Drug rash with eosinophilia and systemic symptoms (DRESS) is a lifethreatening severe cutaneous adverse reaction. Objective: This study aims to study fatal DRESS cases using FAERS database and systematic review. Methods: Data of the FDA Adverse Event Reporting System (FAERS) database were extracted and manipulated. Articles from Pubmed, Embase and CINAHL databases were screened. Results: 0.13% of the adverse events submitted to FAERS was identified as DRESS and the percentage of fatal cases was up to 6.62%. The top five drugs calculated to induce DRESS with the highest number of reported cases were allopurinol, lamotrigine, vancomycin, amoxicillin and carbamazepine. The top five drugs statistically related to fatal outcome with the highest number of reported cases were allopurinol, vancomycin, trimethoprim, sulfamethoxazole and lamotrigine. Skin manifestations remained the main reason for admission and the average time from dose to rash onset was 27.19 days. The most commonly cited culprit medication type were antibiotics (50.00%), anti-gout agents (15.38%) and anti-epileptic drug (11.54%). Conclusions: We discussed fatal cases of DRESS through FAERS system and case reports, hoping to raise awareness when using relevant drugs.

    Keywords: drug reaction with eosinophilia and systemic symptoms, drug-induced hypersensitivity syndrome, FDA Adverse Event Reporting System, Fatal cases, Drug adverse reaction, Systematic review, Disproportionality analysis

    Received: 03 Sep 2024; Accepted: 15 Nov 2024.

    Copyright: © 2024 Liang, An, Zhang, Liu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Xin Liu, Peking Union Medical College Hospital (CAMS), Beijing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.