Infliximab treatment for refractory Kawasaki syndrome - 15/08/11
Abstract |
Objective |
To evaluate the use of tumor necrosis factor (TNF)-⍺ blockade for treatment of patients with Kawasaki syndrome (KS) who fail to become afebrile or who experience persistent arthritis after treatment with intravenous gamma globulin (IVIG) and high-dose aspirin.
Study design |
Cases were retrospectively collected from clinicians throughout the United States who had used infliximab, a chimeric murine/human immunoglobulin (Ig)G1 monoclonal antibody that binds specifically to human TNF-⍺-1, for patients with KS who had either persistent arthritis or persistent or recrudescent fever ≥48 hours following infusion of 2 g/kg of IVIG.
Results |
Response to therapy with cessation of fever occurred in 13 of 16 patients. C-reactive protein (CRP) level was elevated in all but one patient before infliximab infusion, and the level was lower following infusion in all 10 patients in whom it was re-measured within 48 hours of treatment. There were no infusion reactions to infliximab and no complications attributed to infliximab administration in any of the patients.
Conclusion |
The success of TNF-⍺ blockade in this small series of patients suggests a central role of TNF-⍺ in KS pathogenesis. Controlled, randomized clinical trials are warranted to determine the role of anti-TNF-⍺ therapy in KS.
Le texte complet de cet article est disponible en PDF.Mots-clés : ASA, CAA, CRP, eNOS, Ig, IVIG, KS, TNF
Plan
Jane C. Burns is the Principal Investigator of a grant from Centocor for an investigator-initiated clinical trial of infliximab in Kawaski syndrome. Other co-author participants in the Phase I clinical trial are Stanford T. Shulman and Marian E. Melish. Reprint requests: No reprints available. |
Vol 146 - N° 5
P. 662-667 - mai 2005 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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