Cochrane · systematic review · CD014884
Intravenous immunoglobulin for the treatment of Kawasaki disease
Broderick, C, Kobayashi, S, Suto, M, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
VascularAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
17
No studies
4
Included studies
NR
No studies 4 · 19%Ungraded 0 · 0%Very low 3 · 14.3%Low 10 · 47.6%Moderate 4 · 19%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Primary treatment with intravenous immunoglobulin (IVIG) compared to acetylsalicylic acid (ASA) for people with Kawasaki disease
Population: people undergoing initial treatment for KD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of CAAs (up to 30 days) Primary treatment with intravenous immunoglobulin (IVIG) vs acetylsalicylic acid (ASA) | OR 0.6 [0.41, 0.87] | 11 studies · 1437 participants | Moderate Downgraded: risk of bias |
Incidence of any adverse effects after treatment initiation (from 30 days to 30 months) Primary treatment with intravenous immunoglobulin (IVIG) vs acetylsalicylic acid (ASA) | OR 0.57 [0.17, 1.89] | 10 studies · 1376 participants | Very low Downgraded: risk of bias, inconsistency |
Acute coronary syndrome (such as MI or coronary thrombus) (to 30 months) Primary treatment with intravenous immunoglobulin (IVIG) vs acetylsalicylic acid (ASA) | no estimate extracted | 2 studies · 202 participants | Low Downgraded: risk of bias, imprecision |
Duration of fever (days) (acute phase) Primary treatment with intravenous immunoglobulin (IVIG) vs acetylsalicylic acid (ASA) | no estimate extracted | 3 studies · 307 participants | Moderate Downgraded: risk of bias, imprecision |
Need for additional treatment (up to 30 or 60 days) Primary treatment with intravenous immunoglobulin (IVIG) vs acetylsalicylic acid (ASA) | OR 0.27 [0.05, 1.57] | 3 studies · 272 participants | Low Downgraded: risk of bias, imprecision |
Length of hospital stay (days) Primary treatment with intravenous immunoglobulin (IVIG) vs acetylsalicylic acid (ASA) | no estimate extracted | NR | No studies |
Mortality (all‐cause) Primary treatment with intravenous immunoglobulin (IVIG) vs acetylsalicylic acid (ASA) | no estimate extracted | NR | Low Downgraded: risk of bias, imprecision |
Primary treatment with intravenous immunoglobulin (IVIG) compared to different infusion regimens of IVIG for people with Kawasaki disease
Population: people undergoing initial treatment for KD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of CAAs (up to 30 days) Primary treatment with intravenous immunoglobulin (IVIG) vs different infusion regimens of IVIG | OR 0.6 [0.4, 0.89] | 8 studies · 1824 participants | Moderate Downgraded: risk of bias |
Incidence of any adverse effects after treatment initiation ( Primary treatment with intravenous immunoglobulin (IVIG) vs different infusion regimens of IVIG | OR 1.11 [0.52, 2.37] | 6 studies · 1659 participants | Low Downgraded: risk of bias, imprecision |
Acute coronary syndrome (such as MI or coronary thrombus) (up to 7 weeks) Primary treatment with intravenous immunoglobulin (IVIG) vs different infusion regimens of IVIG | no estimate extracted | NR | No studies |
Duration of fever (days) (acute phase) Primary treatment with intravenous immunoglobulin (IVIG) vs different infusion regimens of IVIG | no estimate extracted | 4 studies · 992 participants | Low Downgraded: risk of bias, inconsistency |
Need for additional treatment (up to 6 months) Primary treatment with intravenous immunoglobulin (IVIG) vs different infusion regimens of IVIG | OR 0.29 [0.1, 0.88] | 4 studies · 1125 participants | Low Downgraded: risk of bias, inconsistency |
Length of hospital stay (days) (up to 28 days) Primary treatment with intravenous immunoglobulin (IVIG) vs different infusion regimens of IVIG | no estimate extracted | 3 studies · 752 participants | Low Downgraded: risk of bias, imprecision |
Mortality (all‐cause) (up to 7 weeks) Primary treatment with intravenous immunoglobulin (IVIG) vs different infusion regimens of IVIG | no estimate extracted | 1 study · 549 participants | Moderate Downgraded: imprecision |
Primary treatment with intravenous immunoglobulin (IVIG) compared to prednisolone for people with Kawasaki disease
Population: people undergoing initial treatment for KD
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Incidence of CAAs (acute phase) Primary treatment with intravenous immunoglobulin (IVIG) vs prednisolone | OR 0.6 [0.24, 1.48] | 2 studies · 140 participants | Very low Downgraded: risk of bias, imprecision |
Incidence of any adverse effects after treatment initiation (up to 3 months) Primary treatment with intravenous immunoglobulin (IVIG) vs prednisolone | OR 4.18 [0.19, 89.48] | 1 study · 90 participants | Low Downgraded: risk of bias, imprecision |
Acute coronary syndrome (such as MI or coronary thrombus) (up to 3 months) Primary treatment with intravenous immunoglobulin (IVIG) vs prednisolone | no estimate extracted | 1 study · 90 participants | Low Downgraded: risk of bias, imprecision |
Duration of fever (days) Primary treatment with intravenous immunoglobulin (IVIG) vs prednisolone | no estimate extracted | 2 studies · 140 participants | Very low Downgraded: risk of bias, inconsistency |
Need for additional treatment Primary treatment with intravenous immunoglobulin (IVIG) vs prednisolone | no estimate extracted | NR | No studies |
Length of hospital stay (days) Primary treatment with intravenous immunoglobulin (IVIG) vs prednisolone | no estimate extracted | NR | No studies |
Mortality (all‐cause) (up to 30 days) Primary treatment with intravenous immunoglobulin (IVIG) vs prednisolone | no estimate extracted | 1 study · 90 participants | Low Downgraded: risk of bias, imprecision |