■本研究旨在从临床试验中收集有关儿童静脉注射免疫球蛋白(IVIG)耐药川崎病(KD)可用治疗方法的有效性和安全性的证据。
■这项工作采用了纽卡斯尔-渥太华量表来分析注册文章的质量。使用比较用于治疗IVIG耐药KD的药物的临床试验进行网络荟萃分析。综合数据药物信息系统软件v.1.16.5用于分析英夫利昔单抗是否,第二次IVIG输液,静脉脉冲甲基强的松龙(IVMP)是安全有效的。
■十项研究,涉及704名IVIG耐药KD患者,进行了识别和分析。总的来说,与第二次IVIG输注相比,英夫利昔单抗表现出显著的解热活性(2.46,1.00-6.94).根据毒品等级,英夫利昔单抗是抗IVIG耐药KD的最佳选择。关于不利影响,英夫利昔单抗组更容易发生肝肿大.第二次IVIG输注更有可能导致溶血性贫血。IVMP治疗对心动过缓更敏感,高血糖症,高血压,和体温过低。此外,英夫利昔单抗,IVMP,和第二次IVIG输注显示,在发生冠状动脉瘤(CAA)的风险方面没有显着差异。
■英夫利昔单抗是对抗IVIG耐药KD的最佳选择,IVMP,英夫利昔单抗,和第二次IVIG输注在IVIG耐药KD患者中预防CAA没有显着差异。
■标识符:https://osf.io/3894y。
UNASSIGNED: This study aimed to gather evidence from clinical trials on the efficacy and safety of the available treatments for intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD) in children.
UNASSIGNED: This work adopted the Newcastle-Ottawa scale to analyse the quality of the enrolled articles. A network meta-analysis was performed using clinical trials that compared drugs used to treat IVIG-resistant KD. Aggregate Data Drug Information System software v.1.16.5 was employed to analyse whether infliximab, second IVIG infusions, and intravenous pulse methylprednisolone (IVMP) were safe and effective.
UNASSIGNED: Ten studies, involving 704 patients with IVIG-resistant KD, were identified and analysed. Overall, infliximab exhibited remarkable antipyretic activity compared with the second IVIG infusions (2.46, 1.00-6.94). According to the drug rank, infliximab was the best option against IVIG-resistant KD. Regarding adverse effects, the infliximab group was more prone to hepatomegaly. A second IVIG infusion was more likely to result in haemolytic anaemia. IVMP treatment was more susceptible to bradycardia, hyperglycaemia, hypertension, and hypothermia. In addition, infliximab, IVMP, and the second IVIG infusions showed no significant differences in the risk of developing a coronary artery aneurysm (CAA).
UNASSIGNED: Infliximab was the best option against IVIG-resistant KD, and IVMP, infliximab, and second IVIG infusions have not significant differences of prevent CAA in patients with IVIG-resistant KD.
UNASSIGNED: Identifier: https://osf.io/3894y.