Table 3.

Studies of cyclosporine in treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis

Study	Study design	Treatment regimen	No. of patients treated with Cyclosporine	Hospitalization duration (Days)	SCORTEN predicted mortality	Observed mortality	Conclusion
Valeyrie-Allanore et al.,[24] 2010	Prospective open trial (2005-2010)	3 mg/kg/d × 10d, 2 mg/kg/d × 10d, 1 mg/kg/d × 10d	29	16.2±9	2.75	0	Both the death rates and the progression of detachment seemed lower than expected, suggesting a possible usefulness of cyclosporine in SJS and TEN.
Reese et al.,[20] 2011	Case series	5 mg/kg/d for 5 d to a month	4	-	-	0	Cyclosporine is efficacious with rapid response and reepithelization. Short-term use of cyclosporine did not have adverse reactions or increased infections.
Singh et al.,[14] 2013	Prospective open trial (2011-2012)	3 mg/kg/d × 7d, 2 mg/kg/d × 7d	11	18±5	1.1	0	Cyclosporine has encouraging role in the management of uncomplicated cases of SJS, SJS-TEN overlap, or TEN.
Kirchhof et al.,[25] 2014	Retrospective study (2001-2011)	3-5 mg/kg/d for 7d	15	16±8	2.4	1	Relative mortality benefit of Cyclosporine over IVIg in patients with SJS/ TEN.
Lee et al,[27] 2016	Retrospective study (2011-2014)	3 mg/kg/d × 10 d, 2 mg/kg/d × 10 d, 1 mg/kg/d × 10 d	24	20±15	7.2	3	Relative mortality benefit of Cyclosporine over supportive care in patients with SJS/TEN.
Saoji et al.,[21] 2016	Case series	3-5 mg/kg/d for 10 d	5	12.4	-	0	Cyclosporine even without systemic corticosteroids is safe and effective for the treatment of TEN.
Gonzalez-Herrada et al,[26] 2017	Retrospective (2001-2010) and prospective study (2011-2015)	3 mg/kg/d until reepithelialization subsequently decreasing by 10 mg/day every 48 h	49	-	11.8	5	Cyclosporine reduces mortality in epidermal necrolysis patients.
Mohanty et al.,[15] 2017	Retrospective study (2014-2015)	5 mg/kg/d for 10 d	19	20.39±5.40	3.11	1	Cyclosporine (5 mg/ kg/day) for 10 days from onset of SJS/TEN may decrease the risk of dying, may provide faster healing of lesions, and might lead to early discharge from hospital.
Conner et al.,[22] 2018	Case series	3 mg/kg/d until reepithelialization	4	-	-	1	Rapid stabilization, rapid reepithelialization, low mortality rate, and shortened hospital length of stay with cyclosporine therapy
Vinay et al.,[23]	Case series	3 mg/kg in divided dose	5	-	-	0	Predictable bio-availability and rapid reepithelialisation with intravenous form has potential of reducing hospital stay and incidence of secondary nosocomial infections in SJS/TEN.
Present study	Prospective open trial (2015-2019)	5 mg/kg/d until reepithelialization	16	13.75±3.67	2.55	0	Cyclosporine (5 mg/ kg/day) can be used as the first line-specific immunomodulatory agent in SJS/TEN on account of its efficacy, safety, rapid reepithelization, decrease hospital stay, and reduced morbidity and mortality.