Risk factors for non-response to initial IVIG plus methylprednisolone therapy in children with Kawasaki disease
Authors' conclusion
TBil (≥20 µmol/l), Yang score (≥12) and elevated IL-6 levels are independent risk factors for resistance to IVIG plus methylprednisolone.
Study context
- Population
- High-risk IVIG-resistant children with Kawasaki disease (KD) (Yang and Kobayashi scores) receiving IVIG plus methylprednisolone, January 2020–June 2024of 1511 KD patients
- Participants
- 150 children
- Exposure
- Resistance vs response to initial IVIG plus methylprednisolone
- Resistancen = 13
- Responsen = 137reference
- Outcome
- Independent risk factors for resistance to initial IVIG plus methylprednisolone
Methodological detailspropensity-score matched (1:4) by age and sex, logistic regression
- Propensity-score matched (1:4) by age and sex
- Logistic regression
Main finding
As reported in the abstract
Independent risk factors for resistance
- Total bilirubin (TBil), OR 1.024 (95% CI 1.003-1.048), P = 0.031
- Yang score, OR 1.575 (95% CI 1.204-2.190), P = 0.002
- IL-6 (potential risk factor), OR 1.002 (95% CI 1.000-1.005), P = 0.054
Observational data: associations, not effects.
Further findings
Prediction of resistance (ROC)
AUC TBil (≥20 µmol/l) 0.745 (95% CI: 0.602-0.888) · Yang score (≥12) 0.745 (95% CI: 0.583-0.906)
Sensitivity
Specificity
Original publication
Risk factors for non-response to initial IVIG plus methylprednisolone therapy in children with Kawasaki disease. Rheumatology (Oxford). Published 9 April 2025. doi:10.
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