ArticlePediatric rheumatology online journal2025
Anakinra for infants under six months with Kawasaki disease and coronary artery lesions: a multicenter case series and literature review.
Article in Pediatric rheumatology online journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The Autophagy-Inflammasome Axis as a Molecular Switch: From Persistent Inflammation to Vascular Remodeling in IVIG-Resistant Kawasaki Disease.International journal of molecular sciences · 2026Review
- Hepatobiliary involvement in Kawasaki disease: from cholestatic hepatitis to the hepatic vascular-biliary unit hypothesis-a state-of-the-art review.Frontiers in immunology · 2026Review
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Authors and funding
10 authors.
Funding
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Abstract
backgroundInfants with Kawasaki Disease (KD) have a higher risk of incomplete presentations, IVIG resistance, and coronary artery lesions (CALs). IL-1 plays a key role in the pathogenesis, highlighting its potential as a therapeutic target.
objectiveTo report a multicenter Italian experience and review the literature on anakinra use in KD infants with CALs.
methodsWe retrospectively reviewed charts of patients aged ≤ 6 months treated with anakinra at four Italian centers between 2015 and 2024. A systematic Literature search was also conducted in PubMed, Scopus, Embase, and the Cochrane Library up to October 2024.
resultsEight infants were included. The median age at diagnosis was 2.75 months. Six had incomplete KD. All were resistant to first-line treatment and all developed CALs, which were detected at a median of 9.5 days from fever onset. Anakinra was initiated at a median of 18 days from fever onset and 1.5 days after CALs detection. One patient received only subcutaneous anakinra. Seven infants underwent intravenous administration (median dose 8.5 mg/kg/day), four of whom received an initial bolus (median dose 2.75 mg/kg), and six were subsequently switched to subcutaneous dosing. Median total treatment duration was 22.5 days. CALs completely resolved in five patients, and improved in two. One treatment-related adverse event was reported. The literature review identified nine additional infants ≤ 6 months; seven showed systemic improvement and five had coronary improvement, and no adverse events were reported after anakinra treatment.
conclusionAnakinra may be a promising and well-tolerated option for infants with KD and CALs, especially in IVIG-resistant or high-risk cases. While adverse events were unusual, further studies are needed to confirm its safety and efficacy.
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