307. efficacy of Primary Treatment With Immunoglobulin Plus Cyclosporine for Prevention of Coronary Artery Abnormalities in Kawasaki Disease Patients Predicted to Be at Increased Risk of Ivig Non- Response (Kaica Study): A Controlled, Phase 3, Randomised, Open-Label, Blinded-Endpoints Trial

Hamada, Hiromichi; Suzuki, Hiroyuki; Onouchi, Yoshihiro; Ebata, Ryota; Terai, Masaru; Fuse, Shigeto; Okajima, Yoshitomo; Kurotobi, Shunji; Hirai, Katsuki; Satō, Takashi; Ishiguchi, Yukiko; Okuma, Yasunobu; Takada, Nobuyuki; Yanai, Masaaki; Sato, Junichi; Nakayashiro, Mami; Ayusawa, Mamoru; Yamamoto, Eiichi; Nomura, Yoshio; Hashimura, Yuya; Ouchi, Kazunobu; Masuda, Hiroshi; Takatsuki, Shinichi; Hirono, Keiichi; Ariga, Tadashi

doi:10.1093/rheumatology/kez063.031

Cited by 16 publications

(9 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The recent introduction of treatment with IVIG has reduced this problem. Despite treatment with intravenous gamma globulin, 2% to 4% of patients have coronary abnormalities or develop coronary aneurysms [ 30 ]. Those with giant aneurysms are at risk for stenosis and myocardial ischemia/infarction, which requires systemic anticoagulation with frequent follow-up.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio as a Biomarker for Predicting the Coronary Artery Abnormality in Kawasaki Disease: A Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

We conducted a systematic review and meta-analysis on the relationship between the neutrophil to lymphocyte ratio (NLR) and coronary artery abnormalities (CAA) in patients with Kawasaki disease (KD), according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statements. We searched PubMed, Scopus, Web of Science, Embase, TRIP, Google Scholar, and ProQuest up to the 8th of August 2022. This was done to retrieve eligible studies. No date or language limitations were considered in this study. Methodology quality assessment was conducted according to the Newcastle–Ottawa scale (NOS). Standard mean difference (SMD) and its 95% confidence interval (CI) were used to depict the pooled continuous variables. Finally, 17 articles with 6334 KD patients, of whom 1328 developed CAA, were enrolled in this meta-analysis. NLR level was significantly higher in KD patients with CAA compared to those without CAA (SMD =0.81; 95% CI =0.05–1.57, P = 0.03 ). In addition, NLR level was significantly higher in patients with coronary artery aneurysms than those without coronary artery aneurysms (SMD =2.29; 95% CI =0.18–4.41, P = 0.03 ). However, no significant association between NLR and coronary artery dilation was observed in this meta-analysis (SMD =0.56; 95% CI = -0.86–1.99). There was no publication bias for the pooled SMD of NLR for coronary artery abnormality in KD (Egger’s test P = 0.82 ; Begg’s test P = 0.32 ). The NLR may be useful in monitoring CAA development in these patients and may further imply a mechanistic role in potential inflammation that mediates this process.

show abstract

Section: Discussionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio as a Biomarker for Predicting the Coronary Artery Abnormality in Kawasaki Disease: A Meta-Analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

“…However, 10%-20% of patients with KD fail to respond or develop recrudescent fever 36-48 h after the first dose of IVIG (5), which are termed as IVIG resistance. Previous studies have shown that resistant patients are at higher risk of developing CALs (5,6), and addition use of glucocorticoid or cyclosporine have been confirmed effectively reduce the incidence of CALs in children predicted with IVIG resistance before treatment according to different randomized clinical trails (7,8). Therefore, it is of importance to predict targeted patients who will be IVIG non-responders so that they can benefit from the more aggressive therapy regarding CALs prevention.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Intravenous Immunoglobulin Resistance in Children With Kawasaki Disease: A Meta-Analysis of Case-Control Studies

Liu

Wang

2020

Front. Pediatr.

View full text Add to dashboard Cite

Previous studies have shown that children with Kawasaki disease (KD) who fail to respond to intravenous immunoglobulin (IVIG) therapy are at higher risk of developing coronary artery lesions (CALs). We aimed to conduct a meta-analysis to uncover the risk factors associated with IVIG resistance in children with KD. PubMed, Embase, and Cochrane Library databases were searched up to 31st October 2019, and 23 case-control studies were finally eligible, enrolling 2,053 patients of IVIG resistance and 16,635 patients of IVIG sensitivity. Potential factors were comprehensively analyzed by using stata15 software with a standard meta-analysis procedure and consequently found that in addition to patients with polymorphous rash or swelling of extremities symptoms had a tendency to be non-responders, IVIG resistance was more likely to occur in patients with severe anemia, hypoalbuminemia, decreased baseline platelet count, and elevated levels of erythrocyte sedimentation rate (ESR), total bilirubin, alanine aminotransferase (ALT) and neutrophils percentage. Particularly, male sex, hyponatraemia, increased aspartate aminotransferase (AST), and C-reactive protein (CRP) were confirmed as the risk factors favor IVIG resistance in Mongoloids from Asia countries, but not in Caucasians from non-Asia regions. In summary, we report several risk factors relevant to IVIG resistance in children with KD, which may provide guidance for the prediction of IVIG resistance. But a proposing of an optimal prediction system with high specificity and sensitivity needs further studies because of confounding factors.

show abstract

“…Interestingly, frequency of the risk allele is more than 20 times higher in Japanese compared to Europeans, which may account for higher prevalence of KD in the Japanese population. Together, these genetic and functional data provide evidence for the role of Ca 2+ -mediated signaling pathways in the pathogenesis of KD and for the use of calcineurin inhibitors (49).…”

Section: Related Risk and Referencesmentioning

confidence: 80%

Current State of Precision Medicine in Primary Systemic Vasculitides

et al. 2019

View full text Add to dashboard Cite

307. efficacy of Primary Treatment With Immunoglobulin Plus Cyclosporine for Prevention of Coronary Artery Abnormalities in Kawasaki Disease Patients Predicted to Be at Increased Risk of Ivig Non- Response (Kaica Study): A Controlled, Phase 3, Randomised, Open-Label, Blinded-Endpoints Trial

Cited by 16 publications

References 0 publications

Neutrophil to Lymphocyte Ratio as a Biomarker for Predicting the Coronary Artery Abnormality in Kawasaki Disease: A Meta-Analysis

Neutrophil to Lymphocyte Ratio as a Biomarker for Predicting the Coronary Artery Abnormality in Kawasaki Disease: A Meta-Analysis

Risk Factors of Intravenous Immunoglobulin Resistance in Children With Kawasaki Disease: A Meta-Analysis of Case-Control Studies

Current State of Precision Medicine in Primary Systemic Vasculitides

Contact Info

Product

Resources

About