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. 2019 Feb;49(2):183-191.
doi: 10.4070/kcj.2018.0214. Epub 2018 Nov 8.

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

Gyu Hur  1 , Min Seob Song  2 , Sejung Sohn  3 , Hyoung Doo Lee  4 , Gi Beom Kim  5 , Hwa Jin Cho  6 , Kyung Lim Yoon  7 , Chan Uhng Joo  8 , Myung Chul Hyun  9 , Chul Ho Kim  10
Affiliations

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

Gyu Hur et al. Korean Circ J. 2019 Feb.

Abstract

Background and objectives: We 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.

Methods: Between 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.

Results: Subjects 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).

Conclusions: This 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.

Keywords: Coronary artery; Infliximab; Intravenous immunoglobulins; Kawasaki disease.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1
Figure 1. Treatment modalities and response rates to infliximab and incidence of a significant CAA (z-score >5).
CAA = coronary artery aneurysm; IVIG = intravenous immunoglobulin; IVMP = intravenous methyl prednisolone; MTX = methotrexate.
See this image and copyright information in PMC

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