Abstract | OBJECTIVE: METHODS: Published studies were identified by searches of the Medline and the Cochrane Central Register of Controlled Trials databases as well as hand searches of selected references. Studies were included when (1) all subjects had a stated diagnosis of Kawasaki disease; (2) a corticosteroid preparation was included as part of the initial management of the disease process; (3) a therapeutically matched control group was included for the entire study, or subsets of patients that received a therapeutic intervention identical to the experimental group except for the inclusion of a corticosteroid compound could be identified; and (4) 2-dimensional echocardiography or coronary artery catheterization was performed at least 2 weeks after therapy to detect the presence of coronary aneurysms. Included studies were evaluated for quality and heterogeneity. Meta-analysis was performed using a fixed-effects model. RESULTS: Eight studies fulfilled criteria for inclusion. Because 2 of these studies provided adequate detail to permit evaluation of 2 subgroups each, a total of 10 groups were available for evaluation. The significant heterogeneity that existed among the 10 studies (Q = 21.9, I2 = 59.0) was eliminated when 2 studies with markedly different study designs were removed (Q = 5.59, I2 = 0.00). Meta-analysis of the remaining 8 studies revealed a significant reduction in the incidence of coronary artery aneurysms among patients who received corticosteroid therapy plus aspirin +/- IVIG compared with aspirin +/- IVIG alone (odds ratio [OR] 0.546; 95% confidence interval [CI]: 0.371-0.803); the benefit of corticosteroid therapy was maintained when study subsets of aspirin alone (OR: 0.601; 95% CI: 0.392-0.921) or aspirin + IVIG (OR: 0.352; 95% CI: 0.136-0.909) were compared with matched regimens that contained corticosteroids. CONCLUSION:
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Authors | Angela C Wooditch, Stephen C Aronoff |
Journal | Pediatrics
(Pediatrics)
Vol. 116
Issue 4
Pg. 989-95
(Oct 2005)
ISSN: 1098-4275 [Electronic] United States |
PMID | 16199713
(Publication Type: Journal Article, Meta-Analysis)
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Chemical References |
- Adrenal Cortex Hormones
- Anti-Inflammatory Agents, Non-Steroidal
- Immunoglobulins, Intravenous
- Aspirin
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Topics |
- Adrenal Cortex Hormones
(therapeutic use)
- Anti-Inflammatory Agents, Non-Steroidal
(therapeutic use)
- Aspirin
(therapeutic use)
- Child
- Coronary Aneurysm
(complications, prevention & control)
- Drug Therapy, Combination
- Humans
- Immunoglobulins, Intravenous
(therapeutic use)
- Mucocutaneous Lymph Node Syndrome
(complications, drug therapy)
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