Abstract
Background: Infliximab (IFX) therapy is increasingly used in the treatment of intravenous immunoglobulin (IVIG)-resistant patients with Kawasaki disease (KD).
Purpose: To analyze the effects and safety of IFX therapy in IVIG-resistant patients with KD.
Methods: Fifty-five patients who were administered IFX after initial IVIG between December 2008 and September 2016 were included in this study.
Results: Of the 55 patients treated with IFX for KD, 34 (62％) were male, with a median age of 31 (4–131) months. The median number of days of illness at the initiation of IFX therapy was 10 (7–24) days. In 40 (73％) patients, this treatment was provided as part of second- or third-line therapy. Following IFX administration, 38 (69％) patients became afebrile within 48 h (responders). Ten patients (18％) were given additional treatments after IFX administration. No significant differences in sex, age, or days of IFX administration were observed between the responders (n＝38) and non-responders (n＝17). After IFX administration, the levels of WBC and percentage of neutrophils and CRP decreased. In seven cases, coronary arterial lesions (CAL) were present at the time of IFX administration. In addition, four cases developed CAL after IFX administration. Adverse events occurred in 13 (23％) cases, but no patients developed severe complications.
Discussion/Conclusion: IFX therapy is effective in alleviating fever and reducing the levels of inflammatory markers. CAL occurred at a similar frequency as that observed in previous reports. Although no serious adverse events were observed, close observation is needed in case long-term complications arise.
