Etanercept as Adjunctive Therapy for Kawasaki Disease?

Tweet

This study evaluated the the safety of etanercept (manufactured by Amgen) a tumor necrosis factor-α receptor blocker, in children with acute Kawasaki disease (KD).

Standard therapy of acute KD includes intravenous immunoglobulin (IVIG) and high-dose aspirin, but a substantial number of patients are refractory and require additional treatment. Tumor necrosis factor-α levels are elevated in children with KD, suggesting a role for etanercept in treatment.

The researchers performed a prospective open-label trial of etanercept in 17 patients with KD (age range, 6 months-5 years) meeting clinical criteria and with fever of 10 days.

All received IVIG and high-dose aspirin. They received etanercept immediately after IVIG infusion and then weekly two times.

No patient demonstrated prolonged or recrudescent fever requiring re-treatment with IVIG. No patient showed an increase in coronary artery diameter or new coronary artery dilation/cardiac dysfunction.

Etanercept appears to be safe and well tolerated in children with KD. The data support performance of a placebo-controlled trial.

References:

Prospective Open-Label Trial of Etanercept as Adjunctive Therapy for Kawasaki Disease. Volume 157, Issue 6, Pages 960-966.e1 (December 2010).

IV methylprednisolone-pulse plus IVIG for initial treatment of patients predicted to have refractory Kawasaki disease. Pediatrics, 2012.

Addition of prednisolone to standard treatment with IVIG improves coronary artery outcomes in severe Kawasaki disease http://goo.gl/VTae3

Kawasaki Disease - JAMA Patient Page http://bit.ly/IHglhZ