Infliximab Treatment for Intravenous Immunoglobulin-resistant Kawasaki Disease: a Multicenter Study in Korea
- Author:
Gyu HUR
1
;
Min Seob SONG
;
Sejung SOHN
;
Hyoung Doo LEE
;
Gi Beom KIM
;
Hwa Jin CHO
;
Kyung Lim YOON
;
Chan Uhng JOO
;
Myung Chul HYUN
;
Chul Ho KIM
Author Information
- Publication Type:Multicenter Study
- Keywords: Kawasaki disease; Coronary artery; Infliximab; Intravenous immunoglobulins
- MeSH: Aneurysm; Coronary Vessels; Fever; Humans; Immunoglobulins; Immunoglobulins, Intravenous; Incidence; Infliximab; Korea; Mucocutaneous Lymph Node Syndrome; Prospective Studies; Retrospective Studies; Sample Size; Treatment Failure
- From:Korean Circulation Journal 2019;49(2):183-191
- CountryRepublic of Korea
- Language:English
- 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.
