Targeted Use of Prednisolone with Intravenous Immunoglobulin for Kawasaki Disease
| Autor: | Satoru Iwashima, Shinichiro Sano, Naoe Akiyama, Tetuya Fukuoka, Eiko Nagata, Masashi Harazaki, Hidemasa Sakai |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Prednisolone 030204 cardiovascular system & hematology Mucocutaneous Lymph Node Syndrome 030226 pharmacology & pharmacy Gastroenterology Cohort Studies 03 medical and health sciences 0302 clinical medicine Pharmacotherapy hemic and lymphatic diseases Internal medicine Adjuvant therapy Medicine Humans Pharmacology (medical) Prospective Studies biology business.industry Therapeutic effect Immunoglobulins Intravenous Infant General Medicine Odds ratio medicine.disease Infliximab Child Preschool biology.protein Kawasaki disease Female Antibody business medicine.drug |
| Zdroj: | Clinical drug investigation. 41(1) |
| ISSN: | 1179-1918 |
| Popis: | Intravenous immunoglobulin (IVIG) therapy for acute-stage Kawasaki disease (KD) is the first-line treatment for preventing the development of coronary artery aneurysms (CAA). Corticosteroids (prednisolone) and infliximab are often used in patients at a high risk of CAA or those with CAA at diagnosis; however, there are only a few reports of non-responders to corticosteroids as an adjuvant therapy or rescue alternative to IVIG. In this study, we compared the therapeutic effects of primary and secondary prednisolone with IVIG for KD. We established the following three protocols: A was a secondary rescue prednisolone protocol; B was no prednisolone and second-line infliximab protocol, and C was the primary prednisolone protocol. The indication for prednisolone administration was based on the following: primary prednisolone administration, Kobayashi score; and secondary administration, Shizuoka score. Four hundred and sixty-nine patients were enrolled in the three protocols. A comparison between primary and secondary prednisolone and IVIG, as the first-line therapy revealed that the number of first non-responders in C group was 7 (8.3%), which was significantly lower than the 50 (20.9%) in A group. There was a significant difference in the first and second non-responders among the three groups, and the number of non-responders in A group was 6 (2.5%), which was significantly lower than the 13 (9.9%) in B group (p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink