Cyclosporine and coronary outcomes in Kawasaki disease
Hamada H, Suzuki H, Onouchi Y, Ebata R, Terai M, Fuse S, et al. Efficacy of primary treatment with immunoglobulin plus ciclosporin for prevention of coronary artery abnormalities in patients with Kawasaki disease predicted to be at increased risk of non-response to intravenous immunoglobulin (KAICA): A randomized controlled, open-label blinded endpoints, phase 3 trial. Lancet 2019;393:1128-37.
Abstract Kawasaki disease (KD) is a pediatric vasculitis caused by an unknown trigger in genetically susceptible children. The incidence varies widely across genetically diverse populations. Several associations with HLA Class I alleles have been reported in single cohort studies. Using a genetic approach, from the nine single nucleotide variants (SNVs) associated with KD susceptibility in children of European descent, we identified SNVs near the HLA-C (rs6906846) and HLA-B genes (rs2254556) whose association was replicated in a Japanese descent cohort (rs6906846 p = 0.01, rs2254556 p = 0.005). The risk al...
Hongfei Gu1†, Shuang Shao2†, Jie Liu3,4,5, Zhenqian Fan2, Yu Chen2, Jingxian Ni3,4,5, Conglin Wang6, Jun Tu3,4,5, Xianjia Ning3,4,5, Yongzhong Lou1*, Bin Li1* and Jinghua Wang3,4,5* 1Department of Neurology, Tianjin Haibin People's Hospital, Tianjin, China 2Department of Endocrinology and Metabolism, The Second Hospital of Tianjin Medical University, Tianjin, China 3Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China 4Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China 5Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration i...
Sietse Q. Nagelkerke, Carline E. Tacke, Willemijn B. Breunis, Michael W. T. Tanck, Judy Geissler, Eileen Png, Long T. Hoang, Joris van der Heijden, Ahmad N. M. Naim, Rae S. M. Yeung, Michael L. Levin, Victoria J. Wright, David P. Burgner, Anne-Louise Ponsonby, Justine A. Ellis, Rolando Cimaz, Chisato Shimizu, Jane C. Burns, Karin Fijnvandraat, C. Ellen van der Schoot, Timo K. van den Berg, Martin de Boer, Sonia Davila, Martin L. Hibberd, Taco W. Kuijpers, The International Kawasaki Disease Genetics Consortium , Nagib Dahdah, Isabelle Kone-Paut
Although intravenous immunoglobulin (IVIG) is effective therapy for Kawasaki disease (KD), the most common cause of acquired heart disease in children, 10 –20% of patients are IVIG-resistant and require additional therapy. This group has an increased risk of coronary artery aneurysms (CAA) and there has been no adequately powered, randomized clinical trial in a multi-ethnic population to determine the optimal therapy for IVIG-resistant patients.
Thrombosis is a major adverse outcome associated with coronary artery aneurysms (CAAs) resulting from Kawasaki disease (KD). Clinical guidelines recommend initiation of anticoagulation therapy with maximum CAA diameter (Dmax) ≥8 mm or Z-score ≥ 10. Here, we investigate the role of aneurysm hemodynamics as a superior method for thrombotic risk stratification in KD patients.
Edoardo Marrani, Jane C. Burns, Rolando Cimaz
Congenital Heart Disease, EarlyView.
To describe the epidemiology, response to therapy, and outcomes of Kawasaki disease in a multiethnic community with a large Hispanic and Asian population.
In the report by Masuda and Kobayashi1 in this volume of The Journal, the outcomes are presented for 434 patients with acute Kawasaki disease who received infliximab at some point during their treatment course.1 The data were gathered retrospectively from 274 institutions across Japan and the diversity of approaches to the treatment of acute Kawasaki disease is readily apparent. Infliximab was administered as either the first-, second-, third-, or fourth-line agent in this cohort of patients, many of whom also received a variety of other treatments.
Publication date: Available online 30 December 2017 Source:Canadian Journal of Cardiology Author(s): Jane C. Burns