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KMID : 0368120190490020183
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Korean Circulation Journal
2019 Volume.49 No. 2 p.183 ~ p.191
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Infliximab Treatment for Intravenous Immunoglobulin-resistant Kawasaki Disease: a Multicenter Study in Korea
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Hur Gyu
Song Min-Seob
Sohn Se-Jung
Lee Hyoung-Doo
Kim Gi-Beom
Cho Hwa-Jin
Yoon Kyung-Lim
Joo Chan-Uhng
Hyun Myung-Chul
Kim Chul-Ho
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Abstract
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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.
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KEYWORD
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Kawasaki disease, Coronary artery, Infliximab, Intravenous immunoglobulins
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