Serum Interleukin -21 Level in Patients With Severe Adverse Cutaneous Drug Reaction.

NCT ID: NCT03166241

Last Updated: 2017-05-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-07-31

Study Completion Date

2018-12-31

Brief Summary

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Adverse cutaneous drug reactions are undesirable and typically unanticipated reactions independent of the intended therapeutic purpose of a medication. It may be either immunologic (eg, drug allergy) or non-immunologic. Adverse cutaneous drug reaction produce a wide range of clinical manifestations such as pruritus, maculopapular eruptions, urticaria, angioedema, phototoxic and photo allergic reactions, fixed drug reactions, erythema multiforme,vesiculobullous reactions (eg, Stevens-Johnson syndrome and toxic epidermal necrolysis) and serum sickness .They must be considered in the differential diagnosis of sudden symmetric eruption

Detailed Description

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Erythema multiforme is an acute immune mediated disorder It is a type IV hypersensitivity reaction leading to dermal vasculitis. Erythema multiforme major usually as a result of medications such as sulphonamides, non-steroidal anti-inflammatories and penicillin and there is skin and mucosal involvement.

Steven-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are considered a spectrum of acute life-threatening mucocutaneous reactions that differ only in severity. Both diseases are characterized by mucous membrane and skin involvement, are often caused by medications and are collectively known as epidermal necrolysis or scalded skin syndrome.Stevens-Johnson syndrome (SJS) is classified as an epidermal loss \<10% of the body surface area.Toxic Epidermal Necrolysis (TEN) is indicated by \>30% body surface area erosion. The range of epidermal loss between 10% and 30% is called Stevens-Johnson syndrome-Toxic Epidermal Necrolysis (SJS-TEN) overlap. Severity of illness score \[Score of Toxic Epidermal Necrolysis(TEN) \] has been devised to predict prognosis in patients with Epidermal Necrolysis.This scoring system addresses 7 prognostic factors: age, malignancy, heart rate,Body Surface Area involved, serum urea, serum glucose and serum bicarbonate levels.

Interleukin-21 regulates both innate and adaptive immune responses and it is not only has key roles in antitumour and antiviral responses that promote the development of autoimmune diseases and inflammatory disorders. It is recently discovered member of the type 1 cytokine family which is produced by activated clusters of differentiation 4+ T cells ,Natural killer cells and follicular helper T cells.

Conditions

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Adverse Cutaneous Reaction to Alternative Medical Therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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study group

measure serum interleukin 21 level in patients with severe adverse drug reaction who show change in serum interleukin 21 before and after therapy the following investigation will be done at the begning of the study to patients: Complete Blood Picture Erythrocyte Sedimentation Rate Random blood sugar Liver function tests Kidney function tests

Group Type EXPERIMENTAL

serum interleukin 21

Intervention Type DIAGNOSTIC_TEST

it is cytokine used as a marker to detect it's level in patients with adverse drug reactions

Complete Blood Picture

Intervention Type DIAGNOSTIC_TEST

It is a blood sample will taken from patients to detect any abnormalities in blood component at the start of the study

Liver function test

Intervention Type DIAGNOSTIC_TEST

It is a blood sample will taken from patients to detect any associated liver disease at the start of the study

Random Blood Sugar

Intervention Type DIAGNOSTIC_TEST

measure blood sugar in patients included in the study at the start of the study

Erythrocyte Sedimentation Rate

Intervention Type DIAGNOSTIC_TEST

blood sample will be taken from patients to detect any abnormalities in erythrocyte sedimentation rate at the start of the study

Kidney function tests

Intervention Type DIAGNOSTIC_TEST

blood sample will be taken from patients to detect any kidney disease before the start of the study

control group

compare serum interleukin 21 level in patients with severe adverse drug reaction and healthy control subjects

Group Type PLACEBO_COMPARATOR

serum interleukin 21

Intervention Type DIAGNOSTIC_TEST

it is cytokine used as a marker to detect it's level in patients with adverse drug reactions

Interventions

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serum interleukin 21

it is cytokine used as a marker to detect it's level in patients with adverse drug reactions

Intervention Type DIAGNOSTIC_TEST

Complete Blood Picture

It is a blood sample will taken from patients to detect any abnormalities in blood component at the start of the study

Intervention Type DIAGNOSTIC_TEST

Liver function test

It is a blood sample will taken from patients to detect any associated liver disease at the start of the study

Intervention Type DIAGNOSTIC_TEST

Random Blood Sugar

measure blood sugar in patients included in the study at the start of the study

Intervention Type DIAGNOSTIC_TEST

Erythrocyte Sedimentation Rate

blood sample will be taken from patients to detect any abnormalities in erythrocyte sedimentation rate at the start of the study

Intervention Type DIAGNOSTIC_TEST

Kidney function tests

blood sample will be taken from patients to detect any kidney disease before the start of the study

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* 20 patients presenting with adverse cutaneous drug reaction (Erythema multiforme, SJS and TEN )
* Patients with definite drug history.
* Both sex will be included.

Exclusion Criteria

* Patients with a history of topical or systemic treatment (corticosteroids, intralesional steroid injection, immunosuppressive therapy).
* Patients within 4 weeks of the study.
* Patients receiving phototherapy within 6 months of the study.
* Diabetic patients
* Anaemic patients
* Thyroid disorders,
* Chronic liver or Renal diseases
* Atopy and Parathyroid disorders.
* Patients with known autoimmune diseases or cancer.
* Pregnant or lactating womens.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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MAHanna

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Fathya Ali, MD

Role: CONTACT

01000197217

Hanan Ahmed, MD

Role: CONTACT

01064447881

References

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Farshchian M, Ansar A, Zamanian A, Rahmatpour-Rokni G, Kimyai-Asadi A, Farshchian M. Drug-induced skin reactions: a 2-year study. Clin Cosmet Investig Dermatol. 2015 Feb 9;8:53-6. doi: 10.2147/CCID.S75849. eCollection 2015.

Reference Type RESULT
PMID: 25709487 (View on PubMed)

Hidajat C, Loi D. Drug-mediated rash: erythema multiforme versus Stevens-Johnson syndrome. BMJ Case Rep. 2014 Sep 22;2014:bcr2014205543. doi: 10.1136/bcr-2014-205543.

Reference Type RESULT
PMID: 25246464 (View on PubMed)

Ellender RP, Peters CW, Albritton HL, Garcia AJ, Kaye AD. Clinical considerations for epidermal necrolysis. Ochsner J. 2014 Fall;14(3):413-7.

Reference Type RESULT
PMID: 25249808 (View on PubMed)

Gong F, Su Q, Pan YH, Huang X, Shen WH. The emerging role of interleukin-21 in allergic diseases (Review). Biomed Rep. 2013 Nov;1(6):837-839. doi: 10.3892/br.2013.166. Epub 2013 Sep 12.

Reference Type RESULT
PMID: 24649038 (View on PubMed)

Other Identifiers

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ACDR

Identifier Type: -

Identifier Source: org_study_id

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