protocolSection identificationModule nctId: NCT06266221, orgStudyIdInfo id: APHP200073, secondaryIdInfos id: 2022-000712-59, type: EUDRACT_NUMBER, briefTitle: Severe Erythema Multiforme - CORTICO, acronym: SEMCORTICO, statusModule overallStatus: NOT_YET_RECRUITING, startDateStruct date: 2024-05-01, primaryCompletionDateStruct date: 2027-06-01, completionDateStruct date: 2027-11-01, studyFirstPostDateStruct date: 2024-02-20, lastUpdatePostDateStruct date: 2024-02-20, sponsorCollaboratorsModule leadSponsor name: Assistance Publique - Hôpitaux de Paris, class: OTHER, descriptionModule briefSummary: Erythema multiforme (EM) is an acute and often recurrent mucocutaneous disease. EM is considered a hypersensitivity immune-mediated reaction. The two main known triggering factors are Herpes simplex virus (HSV) and Mycoplasma pneumoniae (MP) infections. Typical target skin lesions characterize EM, especially oral MMs. EM is in fact mainly linked to the oral MM involvement, including intense mucosal pain, impaired food intake, weight loss, hospitalization and potential risk of fibrotic sequelae (oral, ocular, genital, oesophageal, respiratory tract) and recurrences.The objectives of treatment for severe EM in the acute phase are to reduce the duration of lesions, prevent complications and mucosal sequelae. However, despite the lack of evidence and consensus some medical teams often use a short regimen of SCS hoping to obtain a quicker improvement of the condition. However, the use of SCS at the acute phase is not codified and remains debated according to the existent literature. Current studies are mostly retrospective and based on small cohorts or case reports. A randomized, controlled trial would be therefore essential to properly evaluate the benefit of SCS in this pathology and provide strong support to clinicians in their decision making in severe EM during the acute phase.This research will be a Phase III randomized, multicentric, double-blind, controlled trial with two parallel groups. The efficacy of prednisone, oral at 1 mg/kg/day for 3 days, tapered to 0.75 mg/kg/day for 3 days, 0.50 mg/kg/day for 3 days, 0.25 mg/kg/day for 3 days is compared to that of placebo, oral for 12 days or IV methylprednisolone if oral route is impossible because of the self-reported inability for the patient to swallow due to the impacts of the oral lesions, with dosage equivalence at 0.8 mg/kg/day for 3 days, tapered to 0.6 mg/kg/day for 3 days, 0.4 mg/kg/day for 3 days, 0.2 mg/kg/day for 3 days, then stopped, compared to that of placebo.A stratification according to the food intake classification (0,1,2 vs 3) will be performed.An interim analysis is planned after the inclusion of 50 patients. Results of the interim analysis will be presented to the DSMB. During the interim analysis, inclusions may continue., conditionsModule conditions: Erythema Multiforme, designModule studyType: INTERVENTIONAL, phases: PHASE3, designInfo allocation: RANDOMIZED, interventionModel: PARALLEL, primaryPurpose: TREATMENT, maskingInfo masking: QUADRUPLE, whoMasked: PARTICIPANT, whoMasked: CARE_PROVIDER, whoMasked: INVESTIGATOR, whoMasked: OUTCOMES_ASSESSOR, enrollmentInfo count: 96, type: ESTIMATED, armsInterventionsModule interventions name: Prednisone 20 Mg, interventions name: Oral Placebo, interventions name: Methylprednisolone 120 Mg, interventions name: IV Placebo, outcomesModule primaryOutcomes measure: Time to success, primaryOutcomes measure: Evaluation of Pain, primaryOutcomes measure: Food intake, primaryOutcomes measure: Rescue therapy intake, secondaryOutcomes measure: Time to clear or almost clear healing of all sites, secondaryOutcomes measure: Time to fever resolution, secondaryOutcomes measure: Length of hospital stay, secondaryOutcomes measure: Number of days of consumption of level III analgesics, secondaryOutcomes measure: Evaluation of pain, secondaryOutcomes measure: Chopped or solid food intake resumption, secondaryOutcomes measure: Rate of patients in the two groups with need for a rescue therapy, secondaryOutcomes measure: Rate of sequelae, secondaryOutcomes measure: Rate of adverse events during the treatment and follow-up, secondaryOutcomes measure: Evaluation of the quality of life, eligibilityModule sex: ALL, minimumAge: 15 Years, stdAges: CHILD, stdAges: ADULT, stdAges: OLDER_ADULT, contactsLocationsModule, hasResults: False