Early Steroids Are Effective Adjunct in Kawasaki Disease Treatment

Steroids have long been a mainstay of vasculitis treatment, but their role in Kawasaki disease has been unclear due to mixed results from controlled trials. These authors performed a meta-analysis of 16 studies that compared treatment with intravenous immunoglobulin (IVIG) plus steroids versus IVIG alone in 2746 patients with Kawasaki disease. Steroid use was defined as initial (started at the same time as IVIG) or rescue (started after failure of IVIG to reduce fever).

In the pooled analysis, adding steroids to IVIG was associated with a lower risk for coronary artery abnormalities compared with IVIG alone (odds ratio, 0.42). Initial steroids (OR, 0.32) were more effective than rescue steroids (OR, 0.85). The benefit of initial steroids was…