Toxic Epidermal Necrolysis
Conditions
Keywords
TEN
Brief summary
The purpose of this study is to determine whether isotretinoin is helpful in treating patients with an adverse cutaneous drug eruption known as toxic epidermal necrolysis (TEN).
Detailed description
Toxic epidermal necrolysis (TEN) is a potentially life-threatening skin disorder characterized by widespread redness, blistering and peeling of skin. Currently, supportive care in the standard treatment for patients with TEN. Isotretinoin, an FDA-approved medication commonly used for treating severe acne induces differentiation of certain inflammatory cells and thus may potentially be helpful in treating patients with TEN. This is a randomized, placebo-controlled, double-blind, pilot study comparing the efficacy and safety of isotretinoin versus placebo in treating subjects with toxic epidermal necrolysis (TEN). Approximately 40 subjects who satisfy all inclusion and exclusion criteria will be randomly assigned in a 1:1 ratio to either isotretinoin or placebo which they will take for up to 14 days. The end of the study is defined as the time the subject is discharged from the hospital. Participants will primarily be assessed for percent body surface affected (BSA) and number of days of hospitalization.
Interventions
DRUGIsotretinoin
OTHERPlacebo
Sponsors
Massachusetts General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 69 Years
Healthy volunteers
No
Inclusion criteria
1. 18 - 69 years of age 2. Has biopsy-proven toxic epidermal necrolysis (TEN) 3. If female, should not be of childbearing potential defined as: * Have not had menstrual periods for 12 months in a row (menopause) OR * Had bilateral oophorectomy or total hysterectomy OR * Have a ovarian disorder that would make pregnancy not possible
Exclusion criteria
1. Unknown HIV status and unwilling to undergo HIV testing 2. Women of childbearing potential 3. Pregnancy 4. Breastfeeding 5. Fasting serum triglyceride levels \>25% of upper limit of normal 6. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase levels \>2× upper limit of normal (ULN) 7. Known allergy to isotretinoin 8. History of suicidal attempt, psychosis, major depression or other serious mood disorders 9. Currently taking vitamin A supplements, tetracyclines, phenytoin, corticosteroids, IVIg or St. John's Wort 10. Has any condition that, in the opinion of the investigator, would make participation not be in the best interest (for example, compromise the well-being) of the participant or that could prevent, limit, or confound the protocol-specified assessments 11. Participation in an interventional study within the past 30 days.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of days of hospitalization | up to 14 days | Number of days patient will be hospitalized. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percent of body surface affected (BSA) | up to 14 days | Maximum body surface affected with TEN. |
Countries
United States
Outcome results
None listed