Survivors of severe drug reactions for SJS/TEN face long-lasting risk of heart disease, stroke, and related deaths

March 21st, 2025 • National Taiwan University

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. Credit: Prof. Hsien-Yi Chiu

"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 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," said study first author Hsien-Yi Chiu, an associate professor from Department of Dermatology at National Taiwan University.

"Notably, older patients and those who required intensive care during the acute phase are even more vulnerable. 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."

More information:
Hsien-Yi Chiu, Ying-Ming Chiu, Risk of cardiovascular morbidity and mortality in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis survivors, JAMA Dermatology (2025). DOI:10.1001/jamadermatol.2024.5881

Provided by National Taiwan University