Infliximab treatment for intravenous immunoglobulin-resistant kawasaki disease

A multicenter study in Korea

Gyu Hur, 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

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)183-191
Number of pages9
JournalKorean Circulation Journal
Volume49
Issue number2
DOIs
StatePublished - 1 Feb 2019

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Mucocutaneous Lymph Node Syndrome
Intravenous Immunoglobulins
Korea
Multicenter Studies
Coronary Aneurysm
Coronary Vessels
Incidence
Therapeutics
Treatment Failure
Sample Size
Infliximab
Fever
Prospective Studies

Keywords

  • Coronary artery
  • Infliximab
  • Intravenous immunoglobulins
  • Kawasaki disease

Cite this

Hur, Gyu ; Seob Song, Min ; Sohn, Sejung ; Doo Lee, Hyoung ; Kim, Gi Beom ; Jin Cho, Hwa ; Lim Yoon, Kyung ; Uhng Joo, Chan ; Chul Hyun, Myung ; Ho Kim, Chul. / Infliximab treatment for intravenous immunoglobulin-resistant kawasaki disease : A multicenter study in Korea. In: Korean Circulation Journal. 2019 ; Vol. 49, No. 2. pp. 183-191.
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title = "Infliximab treatment for intravenous immunoglobulin-resistant kawasaki disease: A multicenter study in Korea",
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.",
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Hur, G, Seob Song, M, Sohn, S, Doo Lee, H, Kim, GB, Jin Cho, H, Lim Yoon, K, Uhng Joo, C, Chul Hyun, M & Ho Kim, C 2019, 'Infliximab treatment for intravenous immunoglobulin-resistant kawasaki disease: A multicenter study in Korea', Korean Circulation Journal, vol. 49, no. 2, pp. 183-191. https://doi.org/10.4070/kcj.2018.0214

Infliximab treatment for intravenous immunoglobulin-resistant kawasaki disease : A multicenter study in Korea. / Hur, Gyu; Seob Song, Min; Sohn, Sejung; Doo Lee, Hyoung; Kim, Gi Beom; Jin Cho, Hwa; Lim Yoon, Kyung; Uhng Joo, Chan; Chul Hyun, Myung; Ho Kim, Chul.

In: Korean Circulation Journal, Vol. 49, No. 2, 01.02.2019, p. 183-191.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Infliximab treatment for intravenous immunoglobulin-resistant kawasaki disease

T2 - A multicenter study in Korea

AU - Hur, Gyu

AU - Seob Song, Min

AU - Sohn, Sejung

AU - Doo Lee, Hyoung

AU - Kim, Gi Beom

AU - Jin Cho, Hwa

AU - Lim Yoon, Kyung

AU - Uhng Joo, Chan

AU - Chul Hyun, Myung

AU - Ho Kim, Chul

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N2 - 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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KW - Infliximab

KW - Intravenous immunoglobulins

KW - Kawasaki disease

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DO - 10.4070/kcj.2018.0214

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