Infliximab for the Treatment of Refractory Kawasaki Disease: A Nationwide Survey in Japan

Masuda, Hiroshi; Kobayashi, Toshimitsu; Hachiya, Akira; Nakashima, Yasutaka; Shimizu, Hiroyuki; Nozawa, Tomo; Ogihara, Yoshito; Ito, Shuichi; Takatsuki, Shinichi; Katsumata, Nobuyuki; Suzuki, Yasuo; Takenaka, Satoshi; Hirono, Keiichi; Kobayashi, T.; Suzuki, Hiroshi; Suganuma, Eisuke; Takahashi, Kei; Saji, Tsutomu; Matsuzaki, Satoshi; Yamazaki, Shoko; Ikeda, Kazuyuki; Hara, Takuma; Kanetaka, Taichi; Kizawa, Toshitaka; Kikuchi, Masako; Hara, Ryoki; Fujii, Kentaro; Takahashi, Mamoru; Sonoda, Kaori; Yoshihashi, Tomokuni; Imagawa, Tomoyuki; Yamazaki, Kazuko; Ebato, Takasuke; Oana, Shinji; Murase, Ayako; Sakaki, Shinichiro; Fujimoto, Takeshi; Ohsawa, Yutaka; Shirai, Ryota; Takeuchi, Ichiro; Naoi, Kazuyuki; Kenmotsu, Yasushi; Goto, Chiaki; Kise, Hiroaki; Okada, Seigo; Kishimoto, Sayuri; Oba, Utako; Ozawa, Sayaka; Seki, Mitsuru; Odagiri, Tesshu; Shiono, Junko; Nagumo, Kiyoshi; Kimura, Mitsuaki; Yoshibayashi, Muneo; Horita, Norihisa; Tsuboi, Tatsuo; Matsubara, Tomoyo; Hara, Satoshi; Ishii, Taku; Hosokawa, Susumu; Kishi, Takayuki; Fukazawa, Ryuji; Ogawa, Satoshi; Ohshima, Masato; Fukunaga, Hideo; Kouzan, Hiroko; Ichihara, Takahiro; Hashimoto, Kunio; Tokunaga, Hirohide; Iwashima, Satoru; Hamahira, Kiyoshi; Ishiguchi, Yukiko; Kajino, Mayumi; Kishi, Kazushi; Nagai, Noriko; Ito, Shigeru; Ogino, Hirotaro; Amaya, Eriko; Doi, Hiraku; Waki, Kenji; Shiraishi, Taisuke; Iwai, Takashi; Sato, Tetsuji; Akimoto, Katsumi; Satō, Takashi; Naito, Hiroyuki; Aihara, Makiko; Fukuda, Yutaka; Imagawa, Kazuo; Shiba, Takeshi; Matsuki, Shigenobu; Miura, Masaru; Araki, Tooru; Furuyama, Hiroaki; Naito, Takeshi; Miyamoto, Tomoyuki

doi:10.1016/j.jpeds.2017.10.013

Cited by 35 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As a result, CA developed in one-third of patients who received IFX and a giant CA occurred as a complication in 5% of patients. Before IFX, nine patients had a giant CA and 21 had a giant CA after IFX (Table 2) [3][4][5][6][7]. The authors did not reveal the precise background of each patient or the long-term clinical course of giant CA.…”

Section: Discussionmentioning

confidence: 96%

“…Burns et al first reported that IFX, a chimeric monoclonal antibody that specifically binds to TNF-α, was effective at treating patients with refractory KD [3]. In 2018, Masuda et al used a nationwide survey of 274 Japanese institutions to analyze 434 patients administered IFX [7]. Of these patients, 363 (83.6%) became afebrile within 2 days, and the white blood cell count and serum CRP levels significantly decreased.…”

Section: Discussionmentioning

confidence: 99%

“…Infliximab (IFX), a chimeric monoclonal antibody that specifically binds to tumor necrosis factor-alpha (TNF-α), has been successfully used in some cases of IVIG-refractory KD. Many case series and randomized controlled studies have revealed that IFX is effective and well-tolerated in patients with IVIG-refractory KD [3][4][5][6][7]. However, the optimal timing and indications of IFX have not been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A 2-Year-Old Boy With Refractory Kawasaki Disease Who Developed a Giant Aneurysm After Successful Treatment With Infliximab

et al. 2019

View full text Add to dashboard Cite

Kawasaki disease (KD) is the leading cause of systemic vasculitis syndrome in infants and in young children, although its cause has still not been elucidated. Coronary aneurysm (CA) is a major and important complication of KD. Patients resistant to intravenous immunoglobulin (IVIG) treatment are at a high risk of CA. Infliximab (IFX) is a chimeric monoclonal antibody that specifically binds to tumor necrosis factor-alpha (TNF-α) and has been successfully used in some cases of IVIG-refractory KD. However, optimal timing for the administration of IFX has not yet been determined. We present a case of a 2-year-old boy with IVIG-refractory KD who developed a giant right coronary artery (RCA) aneurysm after successful treatment with IFX. Treatment with IVIG (2 g/kg), prednisolone (PSL, 2 mg/kg/day), and aspirin (50 mg/kg/day) was initiated on day 2 because of the fulfillment of KD criteria. Additional IVIG (2 g/kg) and ulinastatin (20,000 U/kg) treatment on day 5 and intravenous administration of IFX (5 mg/kg) on day 9 effectively lowered the patient's fever and improved laboratory data. However, the RCA continued to balloon into a giant CA, from 7.3 mm on day 9 to 14.3 mm in diameter at 2 months. IFX is one treatment option for IVIG-refractory KD. However, the timing and indication of IFX treatment should be carefully determined.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A 2-Year-Old Boy With Refractory Kawasaki Disease Who Developed a Giant Aneurysm After Successful Treatment With Infliximab

et al. 2019

View full text Add to dashboard Cite

show abstract

“…7 There is evidence supporting the potential use of infliximab in treatment-resistant cases. 1,8 Individuals treated with infliximab after failing conventional therapy were more likely to defervesce and show biochemical evidence of decreased inflammation. 8 The use of infliximab in KD is likely safe and potentially effective.…”

Section: Discussionmentioning

confidence: 99%

A Case of Adult-Onset Kawasaki Disease Shock Syndrome Complicated by Coronary Aneurysms

et al. 2019

View full text Add to dashboard Cite

We present a case of adult-onset Kawasaki disease shock syndrome complicated by coronary aneurysms, in which profound hypotension and reduced left ventricular ejection fraction were treated successfully with intravenous immunoglobulin. The diagnosis of Kawasaki disease shock syndrome should be considered in cases of rapidly developing shock, particularly in young adults with an infectious prodrome, in whom it may be under-recognized. We advocate for early identification to minimize delays in treatment with intravenous immunoglobulin, which reverses left ventricular dysfunction and decreases risk of longterm sequelae such as coronary artery aneurysms.

show abstract

“…Given that TNF‐α is a key inflammatory cytokine involved in KD, infliximab (IFX), a chimeric monoclonal antibody that binds with high affinity to TNF‐α, has been used for IVIG‐resistant KD. An alternative approach using IFX was analyzed in a nationwide survey of 274 Japanese institutions, which found that IFX was well‐tolerated and potentially effective for treatment of IVIG‐resistant KD . In the Japanese KD guidelines, IFX is used as a third‐line treatment in IVIG‐resistant KD patients .…”

mentioning

confidence: 99%

Infliximab for the treatment of Kawasaki disease

Matsubara

2018

Pediatrics International

Self Cite

View full text Add to dashboard Cite

Infliximab for the Treatment of Refractory Kawasaki Disease: A Nationwide Survey in Japan

Cited by 35 publications

References 21 publications

A 2-Year-Old Boy With Refractory Kawasaki Disease Who Developed a Giant Aneurysm After Successful Treatment With Infliximab

A 2-Year-Old Boy With Refractory Kawasaki Disease Who Developed a Giant Aneurysm After Successful Treatment With Infliximab

A Case of Adult-Onset Kawasaki Disease Shock Syndrome Complicated by Coronary Aneurysms

Infliximab for the treatment of Kawasaki disease

Contact Info

Product

Resources

About