Clinical Outcomes of Low-Dose Methotrexate Therapy as a Second-Line Drug for Intravenous Immunoglobulin-Resistant Kawasaki Disease

Jang, Hye-Jin; Kim, Kyu Yeun; Kim, Dong Soo

doi:10.3349/ymj.2018.59.1.113

Cited by 8 publications

(5 citation statements)

References 26 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The immunosuppressive agent MTX has been occasionally used to treat IVIG-resistant KD26); but to date, it has not been routinely recommended. In our study, we could not assess the benefit of MTX treatment due to the small number of cases.…”

Section: Discussionmentioning

confidence: 99%

Infliximab Treatment for Intravenous Immunoglobulin-resistant Kawasaki Disease: a Multicenter Study in Korea

et al. 2019

View full text Add to dashboard Cite

Background and ObjectivesWe investigated the status of infliximab use in intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) patients and the incidence of coronary artery aneurysms (CAAs) according to treatment regimens.MethodsBetween March 2010 and February 2017, 16 hospitals participated in this study. A total of 102 (32.3±19.9 months, 72 males) who received infliximab at any time after first IVIG treatment failure were enrolled. Data were retrospectively collected using a questionnaire.ResultsSubjects were divided into two groups according to the timing of infliximab administration. Early treatment (group 1) had shorter fever duration (10.5±4.4 days) until infliximab infusion than that in late treatment (group 2) (16.4±4.5 days; p<0.001). We investigated the response rate to infliximab and the incidence of significant CAA (z-score >5). Overall response rate to infliximab was 89/102 (87.3%) and the incidence of significant CAA was lower in group 1 than in group 2 (1/42 [2.4%] vs. 17/60 [28.3%], p<0.001).ConclusionsThis study suggests that the early administration of infliximab may reduce the incidence of significant CAA in patients with IVIG-resistant KD. However, further prospective randomized studies with larger sample sizes are required.

show abstract

Section: Discussionmentioning

confidence: 99%

Infliximab Treatment for Intravenous Immunoglobulin-resistant Kawasaki Disease: a Multicenter Study in Korea

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Elevations of tissue necrosis factors are characteristic feature of KD, so anti-TNF-α agents such as infliximab and etanercept have been studied in the treatment of KD. These agents can rapidly normalize laboratory markers of Showed improvement in reduction of symptoms but no in improvement or prevention of CAL [39] inflammation in IVIG-resistant cases of KD. In a randomized multicenter trial [30], initial IVIG resistant were given infliximab (5 mg/kg IV) or second dose of IVIG.…”

Section: Tumor Necrosis Factor (Tnf)-alpha Inhibitionmentioning

confidence: 99%

Treatment Options for Refractory Kawasaki Disease

Oli¹,

Lu²,

Khati³

2020

View full text Add to dashboard Cite

Kawasaki Disease (KD) is a self-limiting systemic vasculitis common among children under five years of age. Diagnosis of the disease is made primarily from the clinical features presented during the illness. Coronary artery aneurysm (CAA) is the main complication of this disease which can be prevented largely by the early diagnosis and administration of IVIG (Intravenous Immunoglobulin). Even with first dose of IVIG up to 10% -20% of patients develop refractory Kawasaki Disease, i.e., remain unresponsive to initial IVIG treatment. Second dose of IVIG is recommended treatment for refractory Kawasaki Disease but other alternative treatments are also being considered to lower the risk of complications. Different drugs are still in trial phase and some others have limited studies on larger population. Most of the study reports that involved newer drugs have limited patients or are from single centers which are very hard to apply to larger population. We will review general treatment approach in refractory Kawasaki disease.

show abstract

“…The immunosuppressive agent methotrexate has been occasionally used to treat IVIG-resistant KD but did not affect the improvement or prevention of CAL [40].…”

Section: Treatment Of Ivig-resistant Kdmentioning

confidence: 99%

Predictors and management of intravenous immunoglobulin-resistant Kawasaki disease

Song

2019

Korean J Pediatr

View full text Add to dashboard Cite

Kawasaki disease (KD) is a systemic vasculitis that mainly affects younger children. Intravenous immunoglobulin (IVIG) resistant cases are at increasing risk for coronary artery complications. The strategy on prediction of potential nonresponders and treatment of IVIG-resistant patients is now controversial. In this review the definition and predictors of IVIG-resistant KD and current evidence to guide management are discussed.

show abstract

Clinical Outcomes of Low-Dose Methotrexate Therapy as a Second-Line Drug for Intravenous Immunoglobulin-Resistant Kawasaki Disease

Cited by 8 publications

References 26 publications

Infliximab Treatment for Intravenous Immunoglobulin-resistant Kawasaki Disease: a Multicenter Study in Korea

Infliximab Treatment for Intravenous Immunoglobulin-resistant Kawasaki Disease: a Multicenter Study in Korea

Treatment Options for Refractory Kawasaki Disease

Predictors and management of intravenous immunoglobulin-resistant Kawasaki disease

Contact Info

Product

Resources

About