Does Intensified Anti-Inflammatory Therapy Improve Outcomes in Kawasaki Disease?

Adding the anti-TNF antibody infliximab to standard therapy did not reduce immunoglobulin resistance but had some minimal clinical effects.

Although intravenous immunoglobulin (IVIG) therapy is effective in many children with Kawasaki disease (KD), 10% to 20% develop resistance after one infusion. In a double-blind, placebo-controlled trial, researchers examined whether intensifying initial anti-inflammatory treatment with the addition of infliximab improved outcomes in 196 children (age range, 4 weeks–17 years) with KD and fever. Patients were randomized to receive one dose of IV infliximab (5 mg/kg) or placebo immediately before receiving standard treatment with IVIG and aspirin.

The rate of treatment resistance to IVIG (temperature >38°C at 36 hours to 7 days) did not differ between the two groups (11%). However, patients in the infliximab group had shorter duration of fever …

Reviewing Author

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

F. Bruder Stapleton, MD

Disclosures

Consultant/Advisory BoardCareer Physician

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesAmerican Society of Pediatric Nephrology Foundation (Chair)

Does Intensified Anti-Inflammatory Therapy Improve Outcomes in Kawasaki Disease?

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Reviewing Author