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Efficacy of the Delayed Use of Low-dose Aspirin in Intravenous Immunoglobulin Therapy for Acute-phase Kawasaki Disease

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  • Toshimasa Nakada

Abstract

The mainstay of current standard therapy for acute-phase Kawasaki disease (KD) is intravenous immunoglobulin (IVIG) therapy at 2 g/kg. However, the efficacy of combining medium- or high-dose aspirin with IVIG therapy at 2 g/kg has not been fully investigated. Some studies suggested that aspirin may inhibit coronary artery lesion (CAL) prevention in IVIG therapy and that the delayed use of aspirin in IVIG therapy may be beneficial for the suppression of CALs and prevention of coronary artery stenosis in patients with KD. The efficacy of the delayed use of low-dose aspirin in IVIG therapy for acute-phase KD remains unclear. Therefore, this retrospective study aimed to assess the efficacy of the delayed use of low-dose aspirin, when combined with IVIG therapy for acute-phase KD. Data were obtained from 193 KD patients who underwent acute-phase treatment from January 2009 to October 2020 and IVIG therapy at 2 g/kg with the delayed use of aspirin/flurbiprofen. The patients were divided into three groups: (1) low-dose group, in which 40 patients received low-dose aspirin (5 mg/kg/day); (2) medium-dose group, in which 90 patients received medium-dose aspirin (30 mg/kg/day); and (3) flurbiprofen group, in which 63 patients received flurbiprofen (3–5 mg/kg/day). KD patients with liver damage or those present during influenza season underwent flurbiprofen therapy between January 2009 and November 2017. All patients except one received low-dose aspirin after December 2017. The serum albumin level (median 3.40 vs. 3.30 g/dL, P = 0.026) and Egami score (median 1.0 vs. 2.0, P

Suggested Citation

  • Toshimasa Nakada, 2021. "Efficacy of the Delayed Use of Low-dose Aspirin in Intravenous Immunoglobulin Therapy for Acute-phase Kawasaki Disease," European Journal of Medical and Health Sciences, European Open Science, vol. 3(1), pages 121-126, January.
    • Handle: RePEc:epw:ejmed0:v:3:y:2021:i:1:id:40691
    DOI: 10.24018/ejmed.2021.3.1.691
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    1. Xiaolan Zheng & Peng Yue & Lei Liu & Changqing Tang & Fan Ma & Yi Zhang & Chuan Wang & Hongyu Duan & Kaiyu Zhou & Yimin Hua & Gang Wu & Yifei Li, 2019. "Efficacy between low and high dose aspirin for the initial treatment of Kawasaki disease: Current evidence based on a meta-analysis," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
    2. Toshimasa Nakada, 2020. "Acute Phase Treatment and Medium-Term Outcomes in Kawasaki Disease," European Journal of Medical and Health Sciences, European Open Science, vol. 2(4), July.
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