Cargando…

Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study

Kawasaki Disease (KD) is the most common acquired pediatric heart disease in the developed world. Rapid infusion of high-dose intravenous immunoglobulin is the standard therapy. Different manufacturing processes of IVIG may influence their efficacy. This study aims to conduct a head to head comparis...

Descripción completa

Detalles Bibliográficos
Autores principales: Kuo, Ni-Chun, Lin, Ching-Heng, Lin, Ming-Chih
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10616269/
https://www.ncbi.nlm.nih.gov/pubmed/37903825
http://dx.doi.org/10.1038/s41598-023-45092-5
_version_ 1785129357089439744
author Kuo, Ni-Chun
Lin, Ching-Heng
Lin, Ming-Chih
author_facet Kuo, Ni-Chun
Lin, Ching-Heng
Lin, Ming-Chih
author_sort Kuo, Ni-Chun
collection PubMed
description Kawasaki Disease (KD) is the most common acquired pediatric heart disease in the developed world. Rapid infusion of high-dose intravenous immunoglobulin is the standard therapy. Different manufacturing processes of IVIG may influence their efficacy. This study aims to conduct a head to head comparison of two IVIGs, TBSF and Privigen, from a nationwide perspective. The main data source was the National Health Insurance Research Database (NHIRD) of Taiwan. A total of 3368 KD cases involving children under 2 years of age were enrolled from January 2015 to November 2020. The primary endpoint was IVIG resistance, which we defined as the total amount exceeding 26 g in one admission. The secondary endpoints encompassed two distinct criteria: coronary involvement, which was defined as the prolonged use of aspirin or anti-coagulation agents between 180 and 360 days after the index date, and recurrence, which was defined as readmission for IVIG therapy occurring more than 30 days after previous KD index day and continuing until the end of the follow-up period. Privigen demonstrated a lower IVIG resistance rate at 9.4% in comparison to TBSF, which exhibited a rate of 9.7% (odds ratio 0.72, 95% CI 0.52–0.99). Privigen had a lower odds of coronary involvement (odds ratio 0.38, 95% CI 0.18–0.82). There is no difference in recurrence rate (odds ratio 0.60, 95% CI 0.22–1.68). Privigen might have a lower rate of IVIG resistance and reduced coronary artery involvement. The discrepancy may be due to the concentration, the stabilizers, or the source of plasma. Further investigation is needed to compare the effectiveness of different IVIGs in the large randomized controlled clinical trial.
format Online
Article
Text
id pubmed-10616269
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-106162692023-11-01 Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study Kuo, Ni-Chun Lin, Ching-Heng Lin, Ming-Chih Sci Rep Article Kawasaki Disease (KD) is the most common acquired pediatric heart disease in the developed world. Rapid infusion of high-dose intravenous immunoglobulin is the standard therapy. Different manufacturing processes of IVIG may influence their efficacy. This study aims to conduct a head to head comparison of two IVIGs, TBSF and Privigen, from a nationwide perspective. The main data source was the National Health Insurance Research Database (NHIRD) of Taiwan. A total of 3368 KD cases involving children under 2 years of age were enrolled from January 2015 to November 2020. The primary endpoint was IVIG resistance, which we defined as the total amount exceeding 26 g in one admission. The secondary endpoints encompassed two distinct criteria: coronary involvement, which was defined as the prolonged use of aspirin or anti-coagulation agents between 180 and 360 days after the index date, and recurrence, which was defined as readmission for IVIG therapy occurring more than 30 days after previous KD index day and continuing until the end of the follow-up period. Privigen demonstrated a lower IVIG resistance rate at 9.4% in comparison to TBSF, which exhibited a rate of 9.7% (odds ratio 0.72, 95% CI 0.52–0.99). Privigen had a lower odds of coronary involvement (odds ratio 0.38, 95% CI 0.18–0.82). There is no difference in recurrence rate (odds ratio 0.60, 95% CI 0.22–1.68). Privigen might have a lower rate of IVIG resistance and reduced coronary artery involvement. The discrepancy may be due to the concentration, the stabilizers, or the source of plasma. Further investigation is needed to compare the effectiveness of different IVIGs in the large randomized controlled clinical trial. Nature Publishing Group UK 2023-10-30 /pmc/articles/PMC10616269/ /pubmed/37903825 http://dx.doi.org/10.1038/s41598-023-45092-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Kuo, Ni-Chun
Lin, Ching-Heng
Lin, Ming-Chih
Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study
title Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study
title_full Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study
title_fullStr Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study
title_full_unstemmed Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study
title_short Comparative effectiveness of two intravenous immunoglobulin products in children with Kawasaki disease, a nationwide cohort study
title_sort comparative effectiveness of two intravenous immunoglobulin products in children with kawasaki disease, a nationwide cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10616269/
https://www.ncbi.nlm.nih.gov/pubmed/37903825
http://dx.doi.org/10.1038/s41598-023-45092-5
work_keys_str_mv AT kuonichun comparativeeffectivenessoftwointravenousimmunoglobulinproductsinchildrenwithkawasakidiseaseanationwidecohortstudy
AT linchingheng comparativeeffectivenessoftwointravenousimmunoglobulinproductsinchildrenwithkawasakidiseaseanationwidecohortstudy
AT linmingchih comparativeeffectivenessoftwointravenousimmunoglobulinproductsinchildrenwithkawasakidiseaseanationwidecohortstudy