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The Australasian Registry for Severe Cutaneous Adverse Reactions (AUS-SCAR) - Providing a roadmap for closing the diagnostic, patient, and healthcare gaps for a group of rare drug eruptions.


ABSTRACT:

Background

Severe cutaneous adverse reactions (SCAR) are a group of delayed presumed T-cell mediated hypersensitivities associated with significant morbidity and mortality. Despite their shared global healthcare burden and impact, the clinical phenotypes, genomic predisposition, drug causality, and treatment outcomes may vary. We describe the establishment and results from the first Australasian registry for SCAR (AUS-SCAR), that via a collaborative network advances strategies for the prevention, diagnosis and treatment of SCAR.

Methods

Prospective multi-center registry of SCAR in Australian adult and adolescents, with planned regional expansion. The registry collects externally verified phenotypic data drug causality, therapeutics and long-term patient outcomes. In addition, biorepository specimens and DNA are collected at participating sites.

Results

we report on the first 100 patients enrolled in the AUS-SCAR database. DRESS (50%) is the most predominant phenotype followed by SJS/TEN (39%) and AGEP (10%), with median age of 52 years old (IQR 37.5, 66) with 1:1 male-to-female ratio. The median latency for all implicated drugs is highly variable but similar for DRESS (median 15 days IQR 5,25) and SJS/TEN (median 21 days, IQR 7,27), while lowest for AGEP (median 2.5 days, IQR 1,8). Antibiotics (54.5%) are more commonly listed as primary implicated drug compare with non-antibiotics agent (45.5%). Mortality rate at 90 days was highest in SJS/TEN at 23.1%, followed by DRESS (4%) and AGEP (0%).

Conclusion

In the first prospective national phenotypic and biorepository of SCAR in the southern hemisphere we demonstrate notable differences to other reported registries; including DRESS-predominant phenotype, varied antibiotic causality and low overall mortality rate. This study also highlights the lack of standardised preventative pharmacogenomic measures and in vitro/in vivo diagnostic strategies to ascertain drug causality.

Trial registration

ANZCTR ACTRN12619000241134. Registered 19 February 2019.

SUBMITTER: James F 

PROVIDER: S-EPMC11357849 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Publications

The Australasian Registry for Severe Cutaneous Adverse Reactions (AUS-SCAR) - Providing a roadmap for closing the diagnostic, patient, and healthcare gaps for a group of rare drug eruptions.

James Fiona F   Goh Michelle S MS   Vogrin Sara S   Ng Irvin I   Douglas Abby P AP   Holmes Natasha E NE   Chua Kyra Yl KY   De Luca Joseph J   Sharma Pooja P   Zubrinich Celia C   Aung Ar K AK   Gin Douglas D   Lambros Belinda B   Baker Chris C   Foley Peter P   Chong Alvin H AH   Thien Francis F   Fok Jie S JS   Su John J   Scardamaglia Laura L   Awad Andrew A   Tong Steven S   Johnson Douglas D   Godsell Jack J   Arasu Alexis A   Barnes Sara S   Ojaimi Samar S   Mar Adrian A   Yun James J   Ange Nikhita N   Tong Winnie W Y WWY   Carr Andrew A   Loprete Jacqueline J   Katelaris Constance H CH   Slape Dana D   Keat Karuna K   West Timothy A TA   Lee Monique M   Smith William W   Hissaria Pravin P   Sidhu Shireen S   Janson Sonja S   Venkatesan Sudharsan S   Davies Jane J   Lane Michael J MJ   Redmond Andrew M AM   Robertson Ivan I   Legg Amy A   Fernando Suran S   Boyle Therese T   Li Jamma J   Phillips Elizabeth J EJ   Cleland Heather H   Kern Johannes S JS   Trubiano Jason A JA  

The World Allergy Organization journal 20240805 8


<h4>Background</h4>Severe cutaneous adverse reactions (SCAR) are a group of delayed presumed T-cell mediated hypersensitivities associated with significant morbidity and mortality. Despite their shared global healthcare burden and impact, the clinical phenotypes, genomic predisposition, drug causality, and treatment outcomes may vary. We describe the establishment and results from the first Australasian registry for SCAR (AUS-SCAR), that via a collaborative network advances strategies for the pr  ...[more]

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