Treatment of Kawasaki syndrome: A comparison of two dosage regimens of intravenously administered immune globulin

Barron, Karyl S.; Murphy, Daniel J.; Silverman, Earl D.; Ruttenberg, Herbert D.; Wright, Gregory B.; Franklin, Wayne; Goldberg, Stanley J.; Higashino, Stanley M.; Cox, David G.; Lee, Martin

doi:10.1016/s0022-3476(05)80707-3

Cited by 65 publications

(37 citation statements)

References 13 publications

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“…in 4 daily doses was less efficient than one single shot of 1 g IgG/kg body weight. 95 Taking into account results from other autoimmune and inflammatory diseases benefiting from NAbs in IVIG, the rapid and sufficient elevation of NAbs in the circulation seems to be the key for clinical efficacy. There is some chance to confirm or withdraw the clinical importance of peaking IgG and/or maintaining high IgG levels in the circulation for immunomodulation by dividing the intravenous dose given all three to four weeks into aliquots given subcutaneously e.g.…”

Section: Nabs and Dimers In Ivigmentioning

confidence: 99%

Naturally Occurring Antibodies/Autoantibodies in Polyclonal Immunoglobulin Concentrates

Späth

Lutz

2012

Advances in Experimental Medicine and Biology

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It was a long way from the use of hyperimmune animal sera for the treatment of toxin-producing infections to the production of polyclonal, polyspecific human immunoglobulin preparations and the use of NAbs as therapeutic tools for autoimmune and inflammatory diseases. Some highlights of the development of knowledge in blood fractionation techniques, basic science and clinical wisdom are reviewed in this chapter. Proudly we mention the outstanding contribution of Swiss scientists and clinicians in the development of IVIG as clinical tool for some otherwise untreatable diseases or taking advantage of its low adverse event profile in long-term treatment of other chronic autoimmune and inflammatory diseases. This chapter summarizes some of the characteristics and the effects in humans of NAbs which are present in IgG concentrates. We call attention to the fact that the human data remain, at least in part, incomplete, among others because even with the most efficient large-scale techniques available not more than approximately 50% of the total IgG in plasma can be fractionated into an immunoglobulin G concentrate.

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Section: Nabs and Dimers In Ivigmentioning

confidence: 99%

Naturally Occurring Antibodies/Autoantibodies in Polyclonal Immunoglobulin Concentrates

Späth

Lutz

2012

Advances in Experimental Medicine and Biology

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“…4,10,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Briefly, 17 randomized controlled studies with a total of 4020 patients were subjected to our meta-analysis. Thirty-day follow-up data were available for 3720 patients, including 643 with CALs (17.3%); and 60-day follow-up data were available for 3314 patients, including 350 with CALs (10.6%).…”

Section: Subjectsmentioning

confidence: 99%

Meta-analysis of the results of intravenous gamma globulin treatment of coronary artery lesions in Kawasaki disease

et al. 2004

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The objective of this study was to evaluate the efficacy of intravenous gamma globulin (IVGG) therapy on the prevention of coronary artery lesions (CALs) in patients with Kawasaki disease (KD), with reference to the literature on meta-analyses in randomized controlled studies. Studies from 1984 to the end of 2000 obtained from the National Library of Medicine or from the bibliographies of these articles were used in the analysis. The total number of patients with KD covered in 17 articles was 4020. All the articles were examined for the number of doses per day, the duration of administration, and the total number of IVGG doses. The number of patients in each group was counted, and the incidence of CALs was evaluated at 30 or 60 days after onset. The results of these searches were further analyzed by meta-analytical methods. The administration of IVGG significantly decreased the incidence of CALs in a dose-dependent manner: at 30 days after onset the incidence of CALs was 29.4% without IVGG but 21.6% with a total dosage of IVGG < 1000 mg/kg, 10.8% with a total dosage of 1000-2000 mg/kg, and 10.2% with a total dosage of > or =2000 mg/kg. Compared with the incidence of CALs without IVGG, the odds ratio (OR) was 0.662 [95% confidence interval (CI) 0.519-0.815)] at <1000 mg/kg, 0.292 (95% CI 0.222-0.371) with 1000-2000 mg/kg, and 0.274 (95% CI 0.207-0.349) with > or =2000 mg/kg. At 60 days, the values had decreased to 17.3%, 13.8% [OR 0.767 (95% CI 0.585-1.005)], 5.8% [OR 0.296 (95% CI 0.200-0.436)], and 4.9% [OR 0.244 (95% CI 0.170-0.349)], respectively. The meta-analyses also indicated that high doses of IVGG (> or =2000 mg/kg per day) given in a single dose prevented CALs more effectively than the same dosages divided into five daily doses in the patients with KD: The incidence of CALs at 30 days after disease onset was 2.4% with a single dose versus 12.9% with divided doses. Compared with divided doses, the OR with a single dose was 0.164 (95% CI 0.064-0.393) and 2.8% versus 6.1% at 60 days [OR 0.450 (95% CI 0.206-0.956)]. We clearly confirmed that higher doses of IVGG (> or =2000 mg/kg per day) administered in a single infusion were more effective for preventing CALs, as evaluated during both the subacute and convalescent phases of KD.

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“…'4Again, all children showed some improvement in Of the nine patients receiving intravenous immunoglobulin, the age of onset of the dermatomyositis ranged from 1 9 to 11-0 years (mean age 7-8 years). The age range at which intravenous immunoglobulin was given was 8-5 to 11 9 years with a mean age of 106 years.…”

Section: Onn a Sansome V Dubowitzmentioning

confidence: 99%

Intravenous immunoglobulin in juvenile dermatomyositis--four year review of nine cases.

Sansome

Dubowitz

1995

Archives of Disease in Childhood

108

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Treatment of Kawasaki syndrome: A comparison of two dosage regimens of intravenously administered immune globulin

Cited by 65 publications

References 13 publications

Naturally Occurring Antibodies/Autoantibodies in Polyclonal Immunoglobulin Concentrates

Naturally Occurring Antibodies/Autoantibodies in Polyclonal Immunoglobulin Concentrates

Meta-analysis of the results of intravenous gamma globulin treatment of coronary artery lesions in Kawasaki disease

Intravenous immunoglobulin in juvenile dermatomyositis--four year review of nine cases.

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