Cyclosporine Treatment in Patients with Kawasaki Disease and Coronary Artery Aneurysms or Treatment Resistance

IF 3.9 2区 医学 Q1 PEDIATRICS Journal of Pediatrics Pub Date : 2025-01-24 DOI:10.1016/j.jpeds.2025.114479
Irene Bellicini MD , Emelia Bainto BA , Chisato Shimizu MD , Jane C. Burns MD , Adriana H. Tremoulet MD, MAS
{"title":"Cyclosporine Treatment in Patients with Kawasaki Disease and Coronary Artery Aneurysms or Treatment Resistance","authors":"Irene Bellicini MD ,&nbsp;Emelia Bainto BA ,&nbsp;Chisato Shimizu MD ,&nbsp;Jane C. Burns MD ,&nbsp;Adriana H. Tremoulet MD, MAS","doi":"10.1016/j.jpeds.2025.114479","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To describe the clinical course and outcome of 33 patients with Kawasaki disease (KD) treated with cyclosporine (CSA) for coronary artery abnormalities (CAA) or treatment resistance.</div></div><div><h3>Study design</h3><div>Single-center, retrospective study of patients with KD treated from 2013 through 2023 for CAA or treatment resistance. Demographics, laboratory studies, medications, adverse events, and echocardiographic data were analyzed.</div></div><div><h3>Results</h3><div>Of the 33 KD patients treated with CSA, 25 patients received CSA for CAA and 8 for treatment resistance. Four patients received CSA intravenously initially, followed by oral therapy. Since 2014, all patients received CSA orally only. The target 2-hour postdose level (300-600 ng/ml) was best achieved by dividing 5 mg/kg/day every 12 hours. We developed a standardized treatment protocol based on our experiences with this patient population. The patients treated for CAA all showed improved coronary artery Z-scores at both the 2-week and 6-week follow-up. Two patients experienced significant adverse events. One patient had posterior reversible encephalopathy syndrome, while the other developed Epstein-Barr virus-associated lymphoproliferative disorder. Discontinuation of CSA led to complete recovery in both cases.</div></div><div><h3>Conclusions</h3><div>CSA was generally well tolerated in patients with KD and CAA or treatment resistance. Our study contributes to the limited literature on CSA use in KD, providing dosing guidance and advocating for cautious monitoring.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"279 ","pages":"Article 114479"},"PeriodicalIF":3.9000,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0022347625000198","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0

Abstract

Objective

To describe the clinical course and outcome of 33 patients with Kawasaki disease (KD) treated with cyclosporine (CSA) for coronary artery abnormalities (CAA) or treatment resistance.

Study design

Single-center, retrospective study of patients with KD treated from 2013 through 2023 for CAA or treatment resistance. Demographics, laboratory studies, medications, adverse events, and echocardiographic data were analyzed.

Results

Of the 33 KD patients treated with CSA, 25 patients received CSA for CAA and 8 for treatment resistance. Four patients received CSA intravenously initially, followed by oral therapy. Since 2014, all patients received CSA orally only. The target 2-hour postdose level (300-600 ng/ml) was best achieved by dividing 5 mg/kg/day every 12 hours. We developed a standardized treatment protocol based on our experiences with this patient population. The patients treated for CAA all showed improved coronary artery Z-scores at both the 2-week and 6-week follow-up. Two patients experienced significant adverse events. One patient had posterior reversible encephalopathy syndrome, while the other developed Epstein-Barr virus-associated lymphoproliferative disorder. Discontinuation of CSA led to complete recovery in both cases.

Conclusions

CSA was generally well tolerated in patients with KD and CAA or treatment resistance. Our study contributes to the limited literature on CSA use in KD, providing dosing guidance and advocating for cautious monitoring.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
相关文献
Cyclophosphamide use in treatment of refractory Kawasaki disease with coronary artery aneurysms.
IF 2.5 ACS Applied Bio MaterialsPub Date : 2021-03-17 DOI: 10.1186/s12969-021-00526-0
Olha Halyabar, Kevin G Friedman, Robert P Sundel, Annette L Baker, Margaret H Chang, Patrick W Gould, Jane W Newburger, Mary Beth F Son
Atorvastatin safety in Kawasaki disease patients with coronary artery aneurysms.
IF 1.6 4区 医学Pediatric CardiologyPub Date : 2014-01-01 DOI: 10.1007/s00246-013-0746-9
Elizabeth Niedra, Nita Chahal, Cedric Manlhiot, Rae S M Yeung, Brian W McCrindle
Anakinra Treatment in Patients with Acute Kawasaki Disease with Coronary Artery Aneurysms: A Phase I/IIa Trial
IF 5.1 2区 医学Journal of PediatricsPub Date : 2022-04-01 DOI: 10.1016/j.jpeds.2021.12.035
Jincheng Yang PharmD , Sonia Jain PhD , Edmund V. Capparelli PharmD , Brookie M. Best PharmD, MAS , Mary Beth Son MD , Annette Baker RN, MSN, PNP , Jane W. Newburger MD, MPH , Alessandra Franco MD, PhD , Beth F. Printz MD, PhD , Feng He MS , Chisato Shimizu MD , Shinsuke Hoshino MD , Emelia Bainto BA , Elizabeth Moreno BA , Joan Pancheri RN, BSN, CCRC , Jane C. Burns MD , Adriana H. Tremoulet MD, MAS
来源期刊
Journal of Pediatrics
Journal of Pediatrics 医学-小儿科
CiteScore
6.00
自引率
2.00%
发文量
696
审稿时长
31 days
期刊介绍: The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.
期刊最新文献
Are Early, Frequent Echocardiograms Necessary to Improve Outcomes of Neonates with Congenital Diaphragmatic Hernia? Gnathostomiasis Presenting with Migratory Swelling. The Integration of Artificial Intelligence-Powered Psychotherapy Chatbots in Pediatric Care: Scaffold or Substitute? The Risk from widespread Micro- and Nano-Plastic Contamination on a Global Scale and the Threat to Children's Health. How Neonatologists Use Genetic Information.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1