Infliximab for Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Retrospective Study

Son, Mary Beth; Gauvreau, Kimberlee; Burns, Jane C.; Corinaldesi, Elena; Tremoulet, Adriana H.; Watson, Virginia E.; Baker, Annette L.; Fulton, David R.; Sundel, Robert P.; Newburger, Jane W.

doi:10.1016/j.jpeds.2010.10.012

Cited by 164 publications

(121 citation statements)

References 27 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…8 Subsequently, a retrospective review of intravenous immunoglobulin-resistant patients treated with either a second intravenous immunoglobulin or infl iximab showed that patients treated with infl iximab had fewer days of fever (median 8 vs 10 days, p=0·028) and shorter lengths of hospitalisation (median 5·5 vs 6 days, p=0·04) than those treated with a second intravenous immunoglobulin. 9 Interpretation Although the addition of infl iximab to primary treatment in acute Kawasaki disease did not reduce treatment resistance in this randomised clinical trial, infl iximab was shown to be safe and well tolerated, achieved a greater reduction in the left anterior descending coronary artery Z score, and reduced the number of days of fever, laboratory markers of infl ammation, and intravenous immunoglobulin reaction rates. Data are n or n (%).…”

Section: Systematic Reviewmentioning

confidence: 74%

“…Subsequently, a two-centre retrospective review of intravenous immunoglobulin-resistant patients treated with either a second intravenous immunoglobulin (n=86) or infl iximab (n=20) indicated that patients treated with infl iximab had fewer days of fever (median 8 vs 10 days, p=0·028) and shorter lengths of hospital syay (median 5·5 vs 6 days, p=0·04) than those given a second intravenous immunoglobulin. 9 Taken together, these studies suggest that a single infusion of 5 mg per kg of infl iximab is safe and well tolerated.…”

Section: Systematic Reviewmentioning

confidence: 78%

“…8 In a subsequent two-centre retrospective study of intravenous immunoglobulin-resistant disease, retreatment with infl iximab resulted in faster resolution of fever and fewer days of hospitalisation than did a second intravenous immunoglobulin infusion. 9 These data suggest that infl iximab is safe and eff ective in reducing infl ammation in acute Kawasaki disease. Therefore, we postulated that intensifi cation of initial therapy with infl iximab would decrease the rate of resistance to intravenous immunoglobulin and prevent adverse coronary artery outcomes.…”

Section: Introductionmentioning

confidence: 85%

See 2 more Smart Citations

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

et al. 2014

View full text Add to dashboard Cite

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.

show abstract

Section: Systematic Reviewmentioning

confidence: 74%

Section: Systematic Reviewmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 85%

See 1 more Smart Citation

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

et al. 2014

View full text Add to dashboard Cite

show abstract

“…It may be a good alternative to corticosteroids. 73 Orbital involvement in KD is a rare entity that should be considered in the context of other signs and symptoms consistent with the disease.…”

Section: Kawasaki Syndromementioning

confidence: 99%

Non-infectious orbital vasculitides

Perumal

Black

Levin

et al. 2012

Eye

View full text Add to dashboard Cite

“…7,8 Medications, including intravenous corticosteroids and infl iximab, have been studied as potential ® AN OFFICIAL JOURNAL OF THE AMERICAN ACADEMY OF PEDIATRICS VOLUME 2 • ISSUE 2 www.hospitalpediatrics.org therapies for patients with rKD; however, there is no agreement on their indications. [9][10][11][12][13] In this study, we characterized the demographic characteristics and variability in treatment of rKD. We also identifi ed the fi rst medication used in the treatment of rKD; specifi cally, what is the fi rst medication given when the disease is refractory to the initial dose of IVIG.…”

Section: Introductionmentioning

confidence: 99%

Demographic and Treatment Variability of Refractory Kawasaki Disease: A Multicenter Analysis From 2005 to 2009

Ghelani

Pastor²,

Parikh³

2012

Hospital Pediatrics

View full text Add to dashboard Cite

Objective: Approximately 10% to 15% of Kawasaki disease (KD) is refractory to treatment with initial intravenous immunoglobulin (IVIG). However, there is no consensus on pharmacologic treatment of refractory KD (rKD). Demographic characteristics of patients with rKD and regional variability in their treatment in the United States have not been reported on a large scale. The goal of this study was to describe the demographic and treatment variability in rKD by using a large multi-institutional database. Methods: Data were obtained for patients with KD from January 2005 to June 2009 by using the Pediatric Health Information System. Patients who received a single dose of IVIG were labeled as having standard KD (sKD) and those who required additional medications were labeled as having rKD. Results: Of the 5633 patients studied, 4818 (85.5%) received 1 dose of IVIG (sKD) and 815 (14.5%) received >1 medication (rKD). Median age was 30 months (interquartile range: 14-53) and 30 months (interquartile range: 15-54) for rKD and sKD patients, respectively (P= .438). No significant change was noted in the gender or ethnic distribution of patients between rKD and sKD groups. Seasonal distribution of rKD was comparable to sKD. IVIG was the most common (64.5%) initial medication chosen to treat rKD, followed by methylprednisolone (27.1%) and infliximab (8.3%); however, there was significant regional variability. Of patients with rKD, 81% required only 1 additional medication (after the initial IVIG) for treatment. Conclusions: Patients with rKD have similar age, gender, ethnic, and seasonal distribution as sKD patients. IVIG is the most common initial medication chosen to treat rKD; however, there is regional variation.

show abstract

Infliximab for Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Retrospective Study

Cited by 164 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

Non-infectious orbital vasculitides

Demographic and Treatment Variability of Refractory Kawasaki Disease: A Multicenter Analysis From 2005 to 2009

Contact Info

Product

Resources

About