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Corticosteroids for preventing coronary artery aneurysms in children with Kawasaki disease

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Corticosteroids for preventing coronary artery aneurysms in children with Kawasaki disease

Sübutlu məlumatların xülasələri
27.06.2018 • Sonuncu dəyişiklik 27.06.2018
Editors

Initial corticosteroid therapy may reduce the incidence of coronary artery aneurysms in patients with Kawasaki disease.

A systematic review including 8 studies with a total of 1208 subjects was abstracted in DARE. Of these, two (70 participants) were randomised controlled trials, one (294 participants) was a retrospective study, and the designs of the remaining five studies (844 participants) were unclear. Significantly fewer participants experienced coronary artery aneurysms with corticosteroids as compared with control (OR 0.546 95% CI: 0.371, 0.803, P=0.002; 8 studies). Participants receiving corticosteroids plus aspirin and intravenous immunoglobulin (IVIG) had fewer aneurysms than those receiving aspirin plus IVIG alone (OR 0.352, 95% CI: 0.136, 0.909, P=0.031; 3 studies).

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals in RCTs) and limitations in review methdology (the studies that were excluded from the analysis were done so on the basis of heterogeneity rather than quality).

Ədəbiyyat

  1. Wooditch AC, Aronoff SC. Effect of initial corticosteroid therapy on coronary artery aneurysm formation in Kawasaki disease: a meta-analysis of 862 children. Pediatrics 2005;116:989-995.