Evidence map›Paper›PMID 37258054›Full record

Observational studyArchives of disease in childhood2023

Infliximab for intensification of primary therapy for patients with Kawasaki disease and coronary artery aneurysms at diagnosis.

Koichi Miyata, Emelia V Bainto, Xiaoying Sun, Sonia Jain, Kirsten B Dummer, Jane C Burns, Adriana H Tremoulet

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Archives of disease in childhood, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
8.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

  1. Pooled it
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  16. An Update on Kawasaki Disease.Current rheumatology reports · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Koichi MiyataDepartment of Pediatrics, University of California San Diego, La Jolla, California, USA atremoulet@health.ucsd.edu kmiyata@health.ucsd.edu.ORCID 0000-0002-2049-5309
Emelia V BaintoDepartment of Pediatrics, University of California San Diego, La Jolla, California, USA.
Xiaoying SunDepartment of Family Medicine and Public Health, Division of Biostatistics & Bioinformatics, University of California San Diego, La Jolla, California, USA.
Sonia JainDepartment of Family Medicine and Public Health, Division of Biostatistics & Bioinformatics, University of California San Diego, La Jolla, California, USA.
Kirsten B DummerDepartment of Pediatrics, University of California San Diego, La Jolla, California, USA.
Jane C BurnsDepartment of Pediatrics, University of California San Diego, La Jolla, California, USA.
Adriana H TremouletDepartment of Pediatrics, University of California San Diego, La Jolla, California, USA atremoulet@health.ucsd.edu kmiyata@health.ucsd.edu.
University of California San Diego · USUC San Diego Health System · US

Funding

Innate Immune Activation and Endothelial Cell Dysfunction in Acute Kawasaki DiseaseR01HL140898 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BURNS, JANE C, HOFFMAN, HAROLD M · 2018 to 2022
$4.3M
6 · The paper itself

Abstract

objectiveChildren with Kawasaki disease (KD) and an initial echocardiogram that demonstrates coronary artery aneurysms (CAAs, Z score ≥2.5) are at high risk for severe cardiovascular complications. We sought to determine if primary adjunctive infliximab treatment at a dose of either 5 or 10 mg/kg, compared with intravenous immunoglobulin (IVIG) alone, is associated with a greater likelihood of CAA regression in patients with KD with CAA at the time of diagnosis. DESIGN AND

settingSingle-centre observational study. PATIENTS: Children with acute KD and Z score ≥2.5 at baseline.

interventionsPrimary adjunctive infliximab (5 or 10 mg/kg) within 48 hours of initiating IVIG 2 g/kg.

main outcome measuresIncidence of CAA regression to Zmax <2 within 2 months of disease onset.

resultsOf the 168 patients with KD, 111 received IVIG alone and 57 received primary adjunctive infliximab therapy: 39 received 5 mg/kg and 18 received 10 mg/kg. Incidence of CAA regression to Zmax <2 within 2 months was statistically significant at 52%, 62% and 83% in the IVIG alone, IVIG+infliximab 5 mg/kg and IVIG+infliximab 10 mg/kg, respectively. The multivariable logistic regression model adjusting for age, sex, baseline Zmax and bilateral CAA at baseline showed that IVIG plus 10 mg/kg infliximab was significantly associated with a greater likelihood of CAA regression (adjusted OR: 4.45, 95% CI 1.17 to 16.89, p=0.028) compared with IVIG alone. The difference between IVIG+infliximab 5 mg/kg and IVIG alone was not significant.

conclusionsPrimary adjunctive high-dose 10 mg/kg infliximab treatment was associated with a greater likelihood of CAA regression in patients with CAA at the time of diagnosis.

Indexed as

Coronary AneurysmCoronary Artery DiseaseMucocutaneous Lymph Node SyndromeChildCoronary VesselsHumansImmunoglobulins, IntravenousInfantInfliximabRetrospective StudiesImmunoglobulins, IntravenousInfliximabCardiologyInfliximabPaediatricsRheumatology

Identifiers

PMID37258054
PMCPMC10511975
OpenAlexW4378806099

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.