Cardiology Research
Efficacy and Safety of Adjunctive Corticosteroids in Children With Kawasaki Disease: A Systematic Review and Meta-Analysis of Randomized Trials
By Niemat Mohammed Tahir Ali, Ahmad Ayed AlShammari, Rana Alshehri and 11 others.
Abstract
Background
Kawasaki disease is an acute pediatric vasculitis and a major cause of acquired heart disease in children. Although intravenous immunoglobulin (IVIG) with aspirin remains the standard treatment, some patients have persistent inflammation, IVIG resistance, or coronary complications. The role of adjunctive corticosteroids remains debated, particularly across different risk populations and corticosteroid regimens. This systematic review and meta-analysis evaluated the efficacy and safety of adjunctive corticosteroid therapy in children with Kawasaki disease.
Methods
A systematic search of PubMed, Scopus, Cochrane CENTRAL, and Web of Science was conducted to identify randomized controlled trials comparing corticosteroid-containing treatment strategies with non-corticosteroid comparators, including standard IVIG-based initial treatment or additional IVIG in IVIG-resistant disease. The primary outcome was the change in C-reactive protein levels. Secondary outcomes included fever duration, IVIG resistance, laboratory markers, coronary outcomes, and adverse events. Pooled estimates were calculated using random-effects models and reported as mean differences (MD) or risk ratios with 95% confidence intervals (CIs).