Anakinra for infants under six months with Kawasaki disease and coronary artery lesions: a multicenter case series and literature review
Authors' conclusion
Anakinra may be a promising and well-tolerated option for infants with KD and CALs, especially in IVIG-resistant or high-risk cases.
Study context
- Population
- Infants aged ≤ 6 months with Kawasaki disease and coronary artery lesions treated with anakinra, four Italian centres, 2015–2024plus 9 infants from literature
- Participants
- 8 infants
- Outcome
- CALs outcome after anakinra
Methodological detailsfour Italian centres, systematic literature search, Median age at diagnosis 2.75 months; 6 incomplete Kawasaki Disease (KD), coronary artery lesions (CALs) detected at median 9.5 days from fever onset; anakinra started at median 18 days from fever onset and 1.5 days after CALs detection, 1 received only subcutaneous anakinra; 7 IV (median dose 8.5 mg/kg/day), 4 with initial bolus (median 2.75 mg/kg), 6 switched to subcutaneous
- Four Italian centres
- Systematic literature search
- Median age at diagnosis 2.75 months; 6 incomplete KD
- CALs detected at median 9.5 days from fever onset; anakinra started at median 18 days from fever onset and 1.5 days after CALs detection
- 1 received only subcutaneous anakinra; 7 IV (median dose 8.5 mg/kg/day), 4 with initial bolus (median 2.75 mg/kg), 6 switched to subcutaneous
Main finding
As reported in the abstract
CALs completely resolved
5
CALs improved
2
Observational data: associations, not effects.
Further findings
Literature review: infants ≤ 6 months treated with anakinra
- Additional infants identified
- 9
- Systemic improvement
- 7
- Coronary improvement
- 5
Safety
| Outcome | Values |
|---|---|
| Treatment-related adverse events (case series) | Anakinra 1 events |
Adverse events (literature review)
- No adverse events reported after anakinra treatment
Original publication
Anakinra for infants under six months with Kawasaki disease and coronary artery lesions: a multicenter case series and literature review. Pediatr Rheumatol Online J. Published 3 December 2025. doi:10.
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