ALDEN (Drug Causality in SJS/TEN)
ALDEN (Sassolas 2010): per-drug causality for SJS/TEN from delay, drug presence, prechallenge/rechallenge, dechallenge, drug notoriety, and other causes; < 0 very unlikely to ≥ 6 very probable.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Delay from drug intake to index day
- Suggestive: 5-28 days (+3)
- Drug present in body on index day
- Definite (0)
- Prechallenge / rechallenge
- Not done / unknown (0)
- Dechallenge
- Neutral / stopped / unknown (0)
- Drug notoriety
- Strongly associated (+3)
- Another more likely cause
- No
Result: ALDEN score 6 — very probable (>= 6) drug causality.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- < 2
- Very unlikely (< 0) or unlikely (0-1) drug causality.
- 2-5
- Possible (2-3) or probable (4-5).
- >= 6
- Very probable. Per-drug delay/presence/challenge/dechallenge/notoriety/other-cause. A causality assessment, not a treatment order.
What you enter
- Delay from drug intake to index day (points)
- Drug present in body on index day (points)
- Prechallenge / rechallenge (points)
- Dechallenge (points)
- Drug notoriety (points)
- Another more likely cause (−1)
How this is calculated
Sassolas B, Haddad C, Mockenhaupt M, et al. ALDEN, an algorithm for assessment of drug causality in Stevens-Johnson syndrome and toxic epidermal necrolysis: comparison with case-control analysis. Clin Pharmacol Ther. 2010;88(1):60-68. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.