Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial

Abstract We compared the efficacy and safety of infliximab with intravenous immunoglobulin (IVIG), a standard therapy, in a phase 3 trial (NCT01596335) for Japanese patients with Kawasaki disease (KD) showing persistent fever after initial IVIG. Patients with initial IVIG-refractory KD, aged 1–10 ye...

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Autores principales: Masaaki Mori, Takuma Hara, Masako Kikuchi, Hiroyuki Shimizu, Tomoyuki Miyamoto, Satoru Iwashima, Tatsuya Oonishi, Kunio Hashimoto, Norimoto Kobayashi, Kenji Waki, Yasuo Suzuki, Yoshikazu Otsubo, Hiroshi Yamada, Chikao Ishikawa, Taichi Kato, Shigeto Fuse
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Publicado: Nature Portfolio 2018
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Acceso en línea:https://doaj.org/article/2e82f5bb7da04e2db25e2b012cdcb82a
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spelling oai:doaj.org-article:2e82f5bb7da04e2db25e2b012cdcb82a2021-12-02T15:08:19ZInfliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial10.1038/s41598-017-18387-72045-2322https://doaj.org/article/2e82f5bb7da04e2db25e2b012cdcb82a2018-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-18387-7https://doaj.org/toc/2045-2322Abstract We compared the efficacy and safety of infliximab with intravenous immunoglobulin (IVIG), a standard therapy, in a phase 3 trial (NCT01596335) for Japanese patients with Kawasaki disease (KD) showing persistent fever after initial IVIG. Patients with initial IVIG-refractory KD, aged 1–10 years, received a single dose of IV infliximab 5 mg/kg or IV polyethylene glycol-treated human immunoglobulin (VGIH) 2 g/kg on day 0. Primary outcome was defervescence rate within 48 h after the start of treatment. Safety was evaluated through day 56. Overall, 31 patients were randomized (infliximab, n = 16; VGIH, n = 15); 31.3% and 60.0% patients discontinued due to worsening KD. Defervescence rate within 48 h was greater with infliximab (76.7%) than VGIH (37.0%) (p = 0.023), and defervescence was achieved earlier with infliximab (p = 0.0072). Coronary artery lesions occurred in 1 (6.3%) and 3 (20.0%) patients receiving infliximab and VGIH, respectively, up to day 21. Adverse events occurred in 15 (93.8%) and 15 (100.0%) patients in the infliximab and VGIH groups, respectively. No serious adverse events in the infliximab group and one in the VGIH group were observed. Infliximab improved the defervescence rate within 48 h and time to defervescence versus standard therapy, and was well tolerated in patients with IVIG-refractory KD.Masaaki MoriTakuma HaraMasako KikuchiHiroyuki ShimizuTomoyuki MiyamotoSatoru IwashimaTatsuya OonishiKunio HashimotoNorimoto KobayashiKenji WakiYasuo SuzukiYoshikazu OtsuboHiroshi YamadaChikao IshikawaTaichi KatoShigeto FuseNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-10 (2018)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Masaaki Mori
Takuma Hara
Masako Kikuchi
Hiroyuki Shimizu
Tomoyuki Miyamoto
Satoru Iwashima
Tatsuya Oonishi
Kunio Hashimoto
Norimoto Kobayashi
Kenji Waki
Yasuo Suzuki
Yoshikazu Otsubo
Hiroshi Yamada
Chikao Ishikawa
Taichi Kato
Shigeto Fuse
Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial
description Abstract We compared the efficacy and safety of infliximab with intravenous immunoglobulin (IVIG), a standard therapy, in a phase 3 trial (NCT01596335) for Japanese patients with Kawasaki disease (KD) showing persistent fever after initial IVIG. Patients with initial IVIG-refractory KD, aged 1–10 years, received a single dose of IV infliximab 5 mg/kg or IV polyethylene glycol-treated human immunoglobulin (VGIH) 2 g/kg on day 0. Primary outcome was defervescence rate within 48 h after the start of treatment. Safety was evaluated through day 56. Overall, 31 patients were randomized (infliximab, n = 16; VGIH, n = 15); 31.3% and 60.0% patients discontinued due to worsening KD. Defervescence rate within 48 h was greater with infliximab (76.7%) than VGIH (37.0%) (p = 0.023), and defervescence was achieved earlier with infliximab (p = 0.0072). Coronary artery lesions occurred in 1 (6.3%) and 3 (20.0%) patients receiving infliximab and VGIH, respectively, up to day 21. Adverse events occurred in 15 (93.8%) and 15 (100.0%) patients in the infliximab and VGIH groups, respectively. No serious adverse events in the infliximab group and one in the VGIH group were observed. Infliximab improved the defervescence rate within 48 h and time to defervescence versus standard therapy, and was well tolerated in patients with IVIG-refractory KD.
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author Masaaki Mori
Takuma Hara
Masako Kikuchi
Hiroyuki Shimizu
Tomoyuki Miyamoto
Satoru Iwashima
Tatsuya Oonishi
Kunio Hashimoto
Norimoto Kobayashi
Kenji Waki
Yasuo Suzuki
Yoshikazu Otsubo
Hiroshi Yamada
Chikao Ishikawa
Taichi Kato
Shigeto Fuse
author_facet Masaaki Mori
Takuma Hara
Masako Kikuchi
Hiroyuki Shimizu
Tomoyuki Miyamoto
Satoru Iwashima
Tatsuya Oonishi
Kunio Hashimoto
Norimoto Kobayashi
Kenji Waki
Yasuo Suzuki
Yoshikazu Otsubo
Hiroshi Yamada
Chikao Ishikawa
Taichi Kato
Shigeto Fuse
author_sort Masaaki Mori
title Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial
title_short Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial
title_full Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial
title_fullStr Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial
title_full_unstemmed Infliximab versus intravenous immunoglobulin for refractory Kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial
title_sort infliximab versus intravenous immunoglobulin for refractory kawasaki disease: a phase 3, randomized, open-label, active-controlled, parallel-group, multicenter trial
publisher Nature Portfolio
publishDate 2018
url https://doaj.org/article/2e82f5bb7da04e2db25e2b012cdcb82a
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