Key result
Recurrent Kawasaki disease was not associated with a higher rate of coronary artery lesions compared to nonrecurrent disease (0.0% vs. 2.6%, p=1.000) in patients receiving 2 g/kg IVIG therapy.
Why the study?
Current real-world outcomes of recurrent Kawasaki disease patients in the era of 2 g/kg IVIG therapy remain unclear.
Does recurrent Kawasaki disease increase the risk of IVIG resistance and coronary artery lesions compared to nonrecurrent Kawasaki disease?
Cohort (n=201)
No
Does recurrent Kawasaki disease increase the risk of IVIG resistance and coronary artery lesions compared to nonrecurrent Kawasaki disease?
In the era of 2 g/kg IVIG therapy, recurrent Kawasaki disease may no longer be a risk factor for developing coronary artery lesions or IVIG resistance.
Recurrent KD may not increase CAL risk with 2 g/kg IVIG; leaves open need for larger studies before changing risk models.
Studies have shown that recurrent Kawasaki disease (KD) is a risk factor for resistance to initial intravenous immunoglobulin (IVIG) therapy and development of coronary artery lesions (CALs). However, current real-world outcomes of recurrent KD patients remain unclear. The objective of this retrospective study was to elucidate the outcomes of recurrent KD patients in the era of 2 g/kg IVIG therapy. Data were included from 201 KD patients who underwent acute-phase treatment from January 2009 to September 2020, with 184 (91.5%) receiving 2 g/kg IVIG therapy. The patients were divided into 7 with (recurrent group) and 194 without (nonrecurrent group) recurrent KD. At the first onset, the rates of initial IVIG therapy resistance (28.6% vs. 21.5%, P = 1.000), rescue therapy (14.3% vs. 14.4%, P = 1.000), and CALs (0.0% vs. 2.6%, P = 1.000) were similar between the recurrent and nonrecurrent groups. The rates of initial IVIG therapy resistance (14.3% vs. 21.5%, P = 1.000), rescue therapy (14.3% vs. 14.4%, P = 1.000), and CALs (0.0% vs. 2.6%, P = 1.000) were also similar between the recurrent group at the second onset and the nonrecurrent group at the first onset. KD recurrence may no longer be a risk factor for developing CALs in the era of 2 g/kg IVIG therapy, unless CALs appear at the initial episode.
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Toshimasa Nakada (2020) conducted a cohort in Kawasaki disease (n=201). Recurrent Kawasaki disease vs. Nonrecurrent Kawasaki disease was evaluated on Coronary artery lesions (CALs) at first onset (p=1.000). Recurrent Kawasaki disease was not associated with a higher rate of coronary artery lesions compared to nonrecurrent disease (0.0% vs. 2.6%, p=1.000) in patients receiving 2 g/kg IVIG therapy.
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