A novel model for predicting non‐responsiveness to intravenous immunoglobulins in Kawasaki disease: The Singapore experience

Grignani, Robert; Rajgor, Dimple; Leow, Yao-Guang; Heng, Chew‐Kiat; Quek, Ser Tong

doi:10.1111/jpc.14329

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…A risk predictive model whit high sensitivity and specificity to distinguish between IVIG responder and nonresponder may play an important role in guiding clinical therapy. It has been reported that the Kobayashi, Egami, and Sano scoring systems are not suitable for all populations [16][17][18][19]; thus, these predictive models to identify patients at risk of IVIG nonresponsiveness may not be applicable to Chinese patients. This was reflected in the low-sensitivity values of these scoring systems observed in our study.…”

Section: Discussionmentioning

confidence: 99%

Novel Predictive Scoring System for Intravenous Immunoglobulin Resistance Helps Timely Intervention in Kawasaki Disease: The Chinese Experience

Wang,

Huang,

Wang

et al. 2023

Journal of Immunology Research

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Background. Approximately 10%–20% of patients with Kawasaki disease (KD) are nonresponsive to intravenous immunoglobulin (IVIG) treatment, placing them at higher risk of developing coronary heart lesions. Early detection of nonresponsiveness is crucial to curtail this risk; however, the applicability of existing predictive scoring systems is limited to the Japanese population. Our study aimed to identify a predictive scoring system for IVIG resistance in KD specific to the Chinese population. We aimed to assess the utility of three commonly used risk-scoring systems in predicting IVIG resistance and compare them to the newly developed predictive scoring system. Methods. A total of 895 patients with KD were enrolled in this retrospective review and divided into two groups: IVIG responders and nonresponders. Clinical and laboratory variables were compared between the two groups. Multivariable logistic regression models were used to construct a new scoring system. The utility of the existing and new scoring systems was assessed and compared using the area under the receiver operating characteristic curve. Results. Albumin levels, percentage of neutrophils, and hemoglobin were independent predictors of resistance by logistic regression analysis. The new predictive scoring system was derived with improved sensitivity (60.5%) and specificity (87.8%). The area under the receiver operating characteristic curve was 0.818. Conclusion. This study developed a novel risk-scoring system for predicting resistance to IVIG treatment in KD specific to the Chinese population. Although this new model requires further validation, it may be useful for improving prognostic outcomes and reducing the risk of complications associated with KD.

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Section: Discussionmentioning

confidence: 99%

Novel Predictive Scoring System for Intravenous Immunoglobulin Resistance Helps Timely Intervention in Kawasaki Disease: The Chinese Experience

Wang,

Huang,

Wang

et al. 2023

Journal of Immunology Research

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Refractory Kawasaki disease: modified methylprednisolone regimen decreases coronary artery dilatation

Zhang

Yang

et al. 2021

Pediatr Res

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Prediction Models for Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Meta-analysis

et al. 2023

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CONTEXT: Approximately 10% to 20% of patients with Kawasaki disease (KD) are refractory to initial intravenous immunoglobulin (IVIG) therapy. KD is mainly associated with coronary artery abnormalities. OBJECTIVES: To identify and evaluate all developed prediction models for IVIG resistance in patients with KD and synthesize evidence from external validation studies that evaluated their predictive performances. DATA SOURCES: PubMed Medline, Dialog Embase, the Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov were searched from inception until October 5, 2021. STUDY SELECTION: All cohort studies that reported patients diagnosed with KD who underwent an initial IVIG of 2 g/kg were selected. DATA EXTRACTION: Study and patient characteristics and model performance measures. Two authors independently extracted data from the studies. RESULTS: The Kobayashi, Egami, Sano, Formosa, and Harada scores were the only prediction models with 3 or more external validation of the161 model analyses in 48 studies. The summary C–statistics were 0.65 (95% confidence interval [CI]: 0.57–0.73), 0.63 (95% CI: 0.55–0.71), 0.58 (95% CI: 0.55–0.60), 0.50 (95% CI: 0.36–0.63), and 0.63 (95% CI: 0.44–0.78) for the Kobayashi, Egami, Sano, Formosa, and Harada models, respectively. All 5 models showed low positive predictive values (0.14–0.39) and high negative predictive values (0.85–0.92). LIMITATIONS: Potential differences in the characteristics of the target population among studies and lack of assessment of calibrations. CONCLUSIONS: None of the 5 prediction models with external validation accurately distinguished between patients with and without IVIG resistance.

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A novel model for predicting non‐responsiveness to intravenous immunoglobulins in Kawasaki disease: The Singapore experience

Cited by 4 publications

References 24 publications

Novel Predictive Scoring System for Intravenous Immunoglobulin Resistance Helps Timely Intervention in Kawasaki Disease: The Chinese Experience

Novel Predictive Scoring System for Intravenous Immunoglobulin Resistance Helps Timely Intervention in Kawasaki Disease: The Chinese Experience

Refractory Kawasaki disease: modified methylprednisolone regimen decreases coronary artery dilatation

Prediction Models for Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Meta-analysis

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