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Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis

  • Authors:
    • Zhongxing Lu
    • Fen Wang
    • Haitao Lv
  • View Affiliations / Copyright

    Affiliations: Department of Pediatrics, Changzhou Maternal and Child Health Care Hospital, Changzhou, Jiangsu 213023, P.R. China, Department of Pediatrics, Taicang First People's Hospital, Suzhou, Jiangsu 215000, P.R. China, Department of Pediatrics, Soochow Children's Hospital, Suzhou, Jiangsu 215000, P.R. China
    Copyright: © Lu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 15
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    Published online on: November 5, 2020
       https://doi.org/10.3892/etm.2020.9447
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Abstract

The present study aimed to review the relevant studies in order to determine the efficacy of infliximab (IFX) in the treatment of Kawasaki disease (KD). The relevant studies were retrieved using the PubMed, Cochrane and Embase databases. Key sources in the literature were reviewed; all articles published by July 2019 were considered for inclusion. For each study, odds ratios, mean difference and 95% confidence interval (95% CI) were assessed to evaluate study outcomes. A total of 16 studies involving 429 patients were relevant to the questions of interest of the current meta‑analysis. Compared with intravenous immunoglobulin (IVIG), IFX or IFX plus IVIG significantly reduced the incidence of adverse events, including the number of patients with fever, changes in lip and oral cavity and/or cervical lymphadenopathy. The white blood cell (WBC), neutrophil and C‑reactive protein (CRP) levels were also reduced in the IFX or IFX plus IVIG group compared with those in the IVIG or polyethylene glycol‑treated human immunoglobulin (VGIH) groups. The platelet counts, alanine aminotransferase (ALT) levels and Z‑scores were increased in the IFX or IFX plus IVIG groups compared with those in the IVIG or VGIH groups. In the single‑arm studies, the incidence of coronary artery aneurysm was 0.150 (95% CI: 0.024, 0.277), the non‑response rate was 0.097 (95% CI: 0.056, 0.138), and the incidence of adverse events was 0.156 (95% CI: 0.122, 0.190). IFX not only effectively reduced the incidence of fever, conjunctival injection, changes in lip and oral cavity and cervical lymphadenopathy polymorphous exanthema, but also the WBC, neutrophil, ALT and CRP levels. The platelet levels were increased in patients after the IFX therapy compared with patients in the IVIG or VGIH groups. IFX or IFX plus IVIG exhibited improved clinical efficacy in the treatment of KD compared with that of IVIG or VGIH. However, as a limited number of studies was included in the current study, the findings should be verified further.
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Copy and paste a formatted citation
Spandidos Publications style
Lu Z, Wang F and Lv H: Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis. Exp Ther Med 21: 15, 2021.
APA
Lu, Z., Wang, F., & Lv, H. (2021). Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 21, 15. https://doi.org/10.3892/etm.2020.9447
MLA
Lu, Z., Wang, F., Lv, H."Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 21.1 (2021): 15.
Chicago
Lu, Z., Wang, F., Lv, H."Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 21, no. 1 (2021): 15. https://doi.org/10.3892/etm.2020.9447
Copy and paste a formatted citation
x
Spandidos Publications style
Lu Z, Wang F and Lv H: Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis. Exp Ther Med 21: 15, 2021.
APA
Lu, Z., Wang, F., & Lv, H. (2021). Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis. Experimental and Therapeutic Medicine, 21, 15. https://doi.org/10.3892/etm.2020.9447
MLA
Lu, Z., Wang, F., Lv, H."Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 21.1 (2021): 15.
Chicago
Lu, Z., Wang, F., Lv, H."Efficacy of infliximab in the treatment of Kawasaki disease: A systematic review and meta‑analysis". Experimental and Therapeutic Medicine 21, no. 1 (2021): 15. https://doi.org/10.3892/etm.2020.9447
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