{"id":17287,"date":"2022-08-24T04:35:50","date_gmt":"2022-08-24T04:35:50","guid":{"rendered":"http:\/\/www.pidsphil.org\/home\/?page_id=17287"},"modified":"2025-06-14T03:29:34","modified_gmt":"2025-06-14T03:29:34","slug":"journal-2022-vol-23-no-1-original-articles-1","status":"publish","type":"page","link":"https:\/\/www.pidsphil.org\/home\/journal-2022-vol-23-no-1-original-articles-1\/","title":{"rendered":"Journal 2022 Vol.23 No.1 Original Articles 1"},"content":{"rendered":"<p><strong><span style=\"color: #800000;\">Journal 2022 Vol.23 No<\/span><span style=\"color: #800000;\">.1<\/span><\/strong><br \/>\n<strong>A Systematic Review and Meta-Analysis on the Safety and Efficacy of Second Dose Immunoglobulin Versus High Dose Pulse Methylprednisolone in Refractory Kawasaki Disease<\/strong><br \/>\n<strong><em>Catherine Uy Cano, M.D., Teldy Ley-Chua, M.D. and Robert Dennis Garcia, M.D.<\/em><br \/>\nAbstract<br \/>\nBackground:<\/strong> There is limited information available regarding the management of IVIG-refractory Kawasaki Disease (KD).<br \/>\n<strong>Objective:<\/strong> This study aimed to evaluate the safety and efficacy of a second intravenous immunoglobulin (IVIG) infusion versus intravenous methylprednisolone (IVMP) in patients with IVIG-refractory KD.<br \/>\n<strong>Methodology:<\/strong> Cochrane Library, PubMed, Medline, Elsevier (Science Direct), Springer Link and BMJ databases were searched from May 1, 2020 to December 31, 2020. We included randomized controlled trials (RCTs) and high-quality prospective and retrospective studies, with population restricted to children 0 months to 18 years, with KD refractory to initial IVIG at 2g\/kg, who remained febrile for 24-48 hours after completion of initial IVIG, and who received second-line monotherapy with either a second dose IVIG or IVMP. We conducted a meta-analysis using Review Manager [RevMan] 5.4.1 software.<br \/>\n<strong>Results:<\/strong> A total of six studies (n=188 patients) were analyzed. The incidence of coronary artery lesions was comparable between a second dose of IVIG and IVMP (RR 0.82, 0.34-1.96, P=0.66) in patients with IVIG-refractory KD. The rate of fever resolution to a second IVIG, compared to IVMP, was not significantly different between groups (RR 0.97, 0.84-1.13, P=0.72). There was a significantly higher incidence of adverse events in the IVMP group (RR 0.42, 0.26-0.57, P=0.0002), but these were all transient and resolved without further treatment.<br \/>\n<strong>Conclusion:<\/strong> There is no significant difference in the incidence of coronary artery lesions and rate of fever resolution post-retreatment with a second dose of IVIG versus IVMP in IVIG-refractory KD. More adverse events were reported in the IVMP group.<br \/>\n<strong>Keywords:<\/strong>\u00a0Mucocutaneous Lymph Node Syndrome, Kawasaki Disease, Refractory Kawasaki Disease, Immunosuppressant,<br \/>\nIntravenous Immunoglobulin, Methylprednisolone, Second IVIG Infusion<br \/>\n<a href=\"https:\/\/doi.org\/10.56964\/pidspj20222301005\"><strong>https:\/\/doi.org\/10.56964\/pidspj20222301005<\/strong><\/a><br \/>\n<strong><a href=\"https:\/\/www.pidsphil.org\/home\/wp-content\/uploads\/2022\/12\/005_PIDSP-vol-23-no-1_CANO_IVIG.pdf\" target=\"_\" rel=\"noopener\">View Full Article in PDF format<\/a><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Journal 2022 Vol.23 No.1 A Systematic Review and Meta-Analysis on the Safety and Efficacy of Second Dose Immunoglobulin Versus High Dose Pulse Methylprednisolone in Refractory Kawasaki Disease Catherine Uy Cano, M.D., Teldy Ley-Chua, M.D. and Robert Dennis Garcia, M.D. Abstract Background: There is limited information available regarding the management of IVIG-refractory Kawasaki Disease (KD). Objective:  [&#8230;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-17287","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/pages\/17287","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/comments?post=17287"}],"version-history":[{"count":10,"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/pages\/17287\/revisions"}],"predecessor-version":[{"id":19959,"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/pages\/17287\/revisions\/19959"}],"wp:attachment":[{"href":"https:\/\/www.pidsphil.org\/home\/wp-json\/wp\/v2\/media?parent=17287"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}