A multicenter prospective randomized trial of corticosteroids in primary therapy for Kawasaki disease: Clinical course and coronary artery outcome

Inoue, Yoshinari; Okada, Yasunori; Shinohara, Makoto; Kobayashi, Toshimitsu; Kobayashi, T.; Tomomasa, Takeshi; Takeuchi, Kazuo; Morikawa, Akihiro

doi:10.1016/j.jpeds.2006.05.025

Cited by 144 publications

(113 citation statements)

References 27 publications

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“…[14][15][16][17][18][19] A meta-analysis of these studies concluded that the addition of corticosteroids to intravenous immunoglobulin resulted in fewer coronary artery abnormalities than with treatment with intravenous immunoglobulin alone (OR 0·3, 95% CI 0·18-0·5). 20 However, heterogeneity in patient selection and treatment protocols severely limits application to our patient population.…”

Section: Discussionmentioning

confidence: 99%

“…20 However, heterogeneity in patient selection and treatment protocols severely limits application to our patient population. Three studies assessed 3-5 days of intravenous methylprednisolone (2 mg/kg per day) followed by a 2-4 week oral taper, 14,16,19 whereas the remaining three studies used a single pulse of intravenous methylprednisolone (30 mg/kg per day). 15,17,18 Five studies excluded patients with coronary artery abnormalities at baseline, [14][15][16]18,19 and two studies used Japanese scoring systems to select patients likely to be …”

Section: Discussionmentioning

confidence: 99%

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Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

et al. 2014

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SummaryBackground Kawasaki disease, the most common cause of acquired heart disease in developed countries, is a self-limited vasculitis that is treated with high doses of intravenous immunoglobulin. Resistance to intravenous immunoglobulin in Kawasaki disease increases the risk of coronary artery aneurysms. We assessed whether the addition of infl iximab to standard therapy (intravenous immunoglobulin and aspirin) in acute Kawasaki disease reduces the rate of treatment resistance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

et al. 2014

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“…3 (2010) ment of new therapeutic methods that provide alternatives to immunoglobulin is another task. [7][8][9][10] The histopathological investigation of Kawasaki disease is still focused on the coronary artery, as in the past, because coronary arterial lesions are directly associated with fatality and their details have to be elucidated. Regarding organs other than the heart, many histopathological investigations were reported in the 1980s, but rarely reported thereafter as the number of autopsies of Kawasaki disease patients decreased.…”

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confidence: 99%

Kawasaki Disease as a Systemic Vasculitis in Childhood

Takahashi

Oharaseki

Yokouchi

et al. 2010

Annals of Vascular Diseases

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Kawasaki disease is a disease of unknown etiology that most frequently affects infants and children under 5 years of age. Inflammation occurs in medium-sized muscular arteries throughout the body including the coronary artery, being classified as a systemic vasculitis syndrome. Histopathological investigations of Kawasaki disease have mainly focused on the coronary artery because it is directly associated with the cause of death. However, to identify the cause and pathology of Kawasaki disease, it is necessary to investigate lesions of whole organs. Thus, we attempted to review lesions in organs other than the heart and hypotheses of pathogenesis recently attracting attention.

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“…Recently, several pediatricians have focused on effective initial treatments combined with aspirin and IVIG to reduce the occurrence of CAL due to the limited efficacy of additional rescue treatment. 18,[37][38][39][40] We propose that UTI is an effective candidate for intensive initial treatment.…”

Section: Kanai Et Al Initial Ulinastatin Treatment In Kawasaki Diseasmentioning

confidence: 99%

Ulinastatin, a Urinary Trypsin Inhibitor, for the Initial Treatment of Patients With Kawasaki Disease

et al. 2011

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Background-Markedly activated neutrophils or higher plasma levels of neutrophil elastase are involved in the poor response to intravenous immunoglobulin (IVIG) and the formation of coronary artery lesions (CAL) in patients with acute Kawasaki disease. We hypothesized that ulinastatin (UTI), by both direct and indirect suppression of neutrophils, would reduce the occurrence of CAL. Methods and Results-We retrospectively analyzed the clinical records of patients with Kawasaki disease between 1998 and 2009. Three hundred sixty-nine patients were treated with a combination of UTI, aspirin, and IVIG as an initial treatment (UTI group), and 1178 were treated with a conventional initial treatment, and IVIG with aspirin (control group). The baseline characteristics did not demonstrate notable differences between the two groups.

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A multicenter prospective randomized trial of corticosteroids in primary therapy for Kawasaki disease: Clinical course and coronary artery outcome

Cited by 144 publications

References 27 publications

Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

Infliximab for intensification of primary therapy for Kawasaki disease: a phase 3 randomised, double-blind, placebo-controlled trial

Kawasaki Disease as a Systemic Vasculitis in Childhood

Ulinastatin, a Urinary Trypsin Inhibitor, for the Initial Treatment of Patients With Kawasaki Disease

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