§ Mr. FlynnTo ask the Secretary of State for Health how many instances of Stevens-Johnson syndrome and/or toxic epidermal necrolysis have occurred in each of the last five years; and in respect of how many of these cases (a) paracetamol or codeine and (b) other drugs were assessed to be the cause. [33892]
§ Mr. Malone[holding answer 24 June 1996]: The information available centrally is shown in the table.
The estimated numbers of finished consultant episodes—ordinary admissions and day cases combined—in national health service hospitals in England with a principal diagnosis of erythema multiforme—which includes Stevens-Johnson syndrome and toxic epidermal necrolysis—in each of the five years is as follows:
- 1990–91: 821
- 1991–92: 823
- 1992–93: 843
- 1993–94: 859
- 1994–95: 1,148.
Source:
Hospitals Episode Statistics
149WAn individual patient may be included more than once in the figures. The number of cases from these episodes which were assessed as being due to drugs is unknown. Various non-drug causes for erythema multiforme are well recognised.
The Medicines Control Agency holds the following information relating to suspected adverse drug reactions reported through the voluntary yellow card scheme. These data have been mapped to two relevant preferred terms; erythema multiforme (EM)—which includes Stevens-Johnson syndrome—and epidermal necrolysis (EN). The numbers of reported cases for each of the last five years are shown.
Suspected adverse reaction reports of erythema multiforme (EM) and epidermal necrolysis (EN) to the Committee on Safety of Medicines 1991 to 1995 All reports where paracetamol and/or codeine were a suspect drug All reports involving drugs other than paracetamol and/or codeine Year EM EN EM EN 1991 2 0 112 13 1992 4 0 145 19 1993 0 0 139 28 1994 0 0 138 18 1995 1 0 174 20 Totals 7 0 708 98 Some of the reports associated with paracetamol and/or codeine concerned products containing multiple active ingredients. The figures provided are for the number of suspected adverse drug reactions where the reaction began in the year specified. A report of a suspected adverse drug reaction does not necessarily mean that it was caused by the drug cited; other factors may have contributed.
There are fewer cases of erythema multiforme reported to be associated with medicines than the number of cases from hospital statistics. Several factors account for this difference—one patient may account for more than one consultant episode, not all cases of erythema multiforme are drug-induced and not all adverse drug reactions are reported through the yellow card scheme. Therefore, direct comparisons between these two data sources cannot be made.