Efficacy and safety of intravenous immunoglobulin plus prednisolone therapy in patients with Kawasaki disease (Post RAISE): a multicentre, prospective cohort study

Miyata, Koichi; Kaneko, Tetsuji; Morikawa, Yoshihiko; Sakakibara, Hiroshi; Matsushima, Takahiro; Misawa, Masahiro; Takahashi, Tsutomu; Nakazawa, M.; Tamame, Takuya; Tsuchihashi, Takatoshi; Yamashita, Yukio; Obonai, Toshimasa; Chiga, Michiko; Hori, Naoaki; Komiyama, Osamu; Yamagishi, Hiroyuki; Miura, Masaru

doi:10.1016/s2352-4642(18)30293-1

Cited by 74 publications

(59 citation statements)

References 23 publications

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“…Some laboratory indicators are also important for the prediction of IVIG responsiveness, for example, age, sex, number of illness days, platelet count, erythrocyte sedimentation rate, aspartate aminotransferase, hemoglobin concentration, CRP, eosinophil, total bilirubin, lactate dehydrogenase (Kuo et al, 2007;Sleeper et al, 2011), cholesterol (Hwang et al, 2011), serum albumin (Lee et al, 2015a), percentage of neutrophils, and serum sodium level (Moon et al, 2016). Although there are still no definite treatments for KD patients with IVIG resistance, steroid such as prednisolone was reported to reduce the incidence of coronary abnormalities (Miyata et al, 2018). Infliximab (Son et al, 2011), methotrexate and plasma exchange (Hokosaki et al, 2012) have also been reported to benefit KD patients with initial IVIG treatment failure.…”

Section: The Prognosis Of Ivig Resistancementioning

confidence: 99%

Adjuvant herbal therapy for targeting susceptibility genes to Kawasaki disease: An overview of epidemiology, pathogenesis, diagnosis and pharmacological treatment of Kawasaki disease

Tang

Cheng

et al. 2020

Phytomedicine

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Section: The Prognosis Of Ivig Resistancementioning

confidence: 99%

Adjuvant herbal therapy for targeting susceptibility genes to Kawasaki disease: An overview of epidemiology, pathogenesis, diagnosis and pharmacological treatment of Kawasaki disease

Tang

Cheng

et al. 2020

Phytomedicine

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“…Steroid combination therapy is recommended for these high-risk patients by Japanese guidelines [10]. The RAISE study showed that additional prednisolone reduced the non-response to IVIG and decreased the occurrence of CALs in high-risk KD patients [11,12]. Intravenous methylprednisolone plus IVIG also had a positive effect [13,14].…”

Section: Page 4/17mentioning

confidence: 99%

Serum tenascin-C predicts resistance to steroid combination therapy in high-risk Kawasaki disease: A multicenter prospective cohort study

Yoshikane

Okuma

Miyamoto

et al. 2020

Preprint

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Background Tenascin-C (TN-C) is an extracellular matrix glycoprotein related to tissue inflammation. Our previous retrospective study conducted in 2016 revealed that the serum TN-C level was higher in patients with Kawasaki disease (KD) who were resistant to intravenous immunoglobulin (IVIG) and developed coronary artery lesions (CALs). The present study is a prospective cohort study to assess if the serum level of TN-C could be used as a novel biomarker to predict the risk of resistance to initial treatment for high-risk patients. Methods A total of 380 KD patients were registered and provided serum samples for TN-C measurement before commencing their initial treatment. Patients who did not meet the inclusion criteria were excluded from analysis; of the 181 remaining subjects, there were 144 low-risk patients (Kobayashi score: ≤4 points) and 37 high-risk patients (Kobayashi score: ≥5 points). The initial treatments for low-risk patients and high-risk patients were conventional therapy (IVIG with aspirin) and prednisolone combination therapy, respectively. The patient clinical and laboratory data, including the serum TN-C level, were compared between responders and non-responders to initial treatment. Results In the low-risk patients, there was no significant difference in the median levels of serum TN-C between responders and non-responders to initial therapy. However, in the high-risk patients, the median serum TN-C level in non-responders was significantly higher than that in responders (175.8 ng/ml vs 117.6 ng/ml). Conclusions Serum TN-C could be a biomarker for predicting the risk of high-risk patients being non-responsive to steroid combination therapy. Trial registration: This study was a prospective cohort study. It had been performed in accordance with the Declaration of Helsinki and had been approved by the ethics committee in each institute.

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“…Indeed, the Kobayashi score had been evaluated at 6 points which constitutes a 50% risk of IVIG ineffectiveness in KD (29). The benefit of prednisolone administration is well-documented in these circumstances (30,31).…”

Section: Discussionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome With Complete Kawasaki Disease Features Associated With SARS-CoV-2 Infection in a Young Adult. A Case Report

et al. 2020

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A severe multisystem inflammatory syndrome associated with Kawasaki disease manifestations (MIS-C) has been recently reported in children with signs of recent infection with SARS-CoV-2. We here reported the case of a young adult woman who presented the complete manifestations of Kawasaki disease associated with a severe myocarditis, acute respiratory distress syndrome and hemodynamic instability a few weeks after a transient anosmia. The detection of specific antibodies to SARS-CoV-2 in the absence of detection of the virus suggested that the syndrome was the result of a delayed immune response to a recent COVID-19 infection. A combined treatment with colchicine, tocilizumab, high dose immunoglobulins, and methylprednisolone allowed to control the inflammatory process and to limit the development of coronary aneurysm. The patient recovered without sequelae. This case emphasized the importance of SARS-CoV-2 serology for the diagnosis of delayed immune complications of COVID-19. Clinicians caring for adult patients must be aware that not only children but also young adults can be affected by a multisystem inflammatory syndrome with KD features associated with COVID-19.

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Efficacy and safety of intravenous immunoglobulin plus prednisolone therapy in patients with Kawasaki disease (Post RAISE): a multicentre, prospective cohort study

Cited by 74 publications

References 23 publications

Adjuvant herbal therapy for targeting susceptibility genes to Kawasaki disease: An overview of epidemiology, pathogenesis, diagnosis and pharmacological treatment of Kawasaki disease

Adjuvant herbal therapy for targeting susceptibility genes to Kawasaki disease: An overview of epidemiology, pathogenesis, diagnosis and pharmacological treatment of Kawasaki disease

Serum tenascin-C predicts resistance to steroid combination therapy in high-risk Kawasaki disease: A multicenter prospective cohort study

Multisystem Inflammatory Syndrome With Complete Kawasaki Disease Features Associated With SARS-CoV-2 Infection in a Young Adult. A Case Report

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