Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Various adjuncts to IVIg help treat coronary artery abnormalities in pediatric Kawasaki disease

Key clinical point: Adding one of three adjuncts to IVIg appears to aid treatment of coronary artery abnormalities in children with Kawasaki disease.

Major finding: Etanercept reduced change in coronary z score among participants with baseline dilation (P = .04) and without baseline dilation (P = .001), but there was no improvement among participants in the placebo group. Patients who received corticosteroids with IVIg therapy were protected against coronary size progression (coefficient, −1.31), and those patients who received infliximab and IVIg therapy also were protected against coronary size progression at follow-up (coefficient, −1.07).

Study details: In the first study, 201 children received an IVIg infusion followed by either subcutaneous etanercept or placebo. In the second study, 121 children received IVIg followed by either corticosteroids, infliximab, or placebo.

Disclosures: The EATAK trial was funded by the Food and Drug Administration Office of Orphan Product Development, Amgen, and the National Institutes of Health. Dr. Portman and colleagues reported no relevant financial disclosures. The study from Dionne et al. received funding from the McCance Family Foundation and the Vella Fund. One of the authors reported being a paid expert witness for missed diagnoses of Kawasaki disease, which was unrelated to the study. The other authors said they had no conflicts of interest.