Project Summary
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final. In the meantime, results have been published in peer-reviewed journals, as listed below.
What is the research about?
Kawasaki disease is a rare childhood health problem that inflames blood vessels. It can affect any artery or vein in the body. Symptoms include high fever; rash; dry lips; and swollen tongue, hands, and feet. The illness can sometimes cause a dangerous bulge, called an aneurysm, in the coronary artery.
No one knows what causes Kawasaki disease. Most children recover fully after treatment with intravenous immunoglobin, or IVIG. But 10 to 20 percent of children are resistant to IVIG treatment: The treatment doesn’t work well for them, and the fever comes back. These children have a higher risk of aneurysm. Doctors don’t know what treatment works best for them.
In this study, the research team is comparing two treatments for children whose Kawasaki disease comes back. One treatment is another dose of IVIG. The other is a medicine called infliximab.
Who can this research help?
Doctors and parents of children who have Kawasaki disease and are IVIG resistant can use results from this study when planning treatment.
What is the research team doing?
The research team is working with 30 hospitals across the United States to recruit 250 children who have Kawasaki disease and are IVIG resistant. The team is assigning IVIG-resistant patients by chance to receive either a second dose of IVIG or infliximab. Both are single treatments given at the hospital.
To see if patients’ fever goes away within 24 hours of starting treatment and stays normal for a week, the research team is following up with parents. The team is also tracking patients for
- Signs of infection
- Signs of aneurysm
- Total days with a fever after treatment
- Total days in the hospital
- Complications from treatment
Parents of children with Kawasaki disease and adults previously diagnosed with Kawasaki disease are working with the research team to plan and conduct the study.
Research methods at a glance
| Design Elements | Description |
|---|---|
| Design | Randomized controlled trial |
| Population | Children ages 4 weeks to 17 years who have a return of fever following initial treatment for Kawasaki disease |
| Interventions/ Comparators |
|
| Outcomes |
Primary: cessation of fever within 24 hours of treatment initiation, no recurrence within 7 days Secondary: cessation of fever within 24 hours of treatment completion, change in white blood cell count, absolute neutrophil count, and high-sensitivity C-reactive protein, change in Zworst score, total number of fever days; duration of hospitalization, treatment reactions and complications |
| Timeframe | 7-day follow-up for primary outcomes |
COVID-19-Related Study
Summary
This study received additional funding in 2020 to quickly initiate new research related to COVID-19. The additional research is in progress. PCORI will post the research findings on this page once the results are final.
A new, rare health problem that can look like Kawasaki disease has appeared in children living in communities heavily affected by COVID-19. With this enhancement, the research team will describe the clinical features and collect blood samples from children with this new health problem and compare the clinical features to Kawasaki disease.
To learn about children’s history of exposure and initial symptoms, the parents will complete a questionnaire. The study will make use of the network of Kawasaki disease research experts and clinical centers used in the original award.
Enhancement Award Amount: $199,500
Journal Citations
Results of This Project
Related Journal Citations
Project Information
Patient / Caregiver Partners
- Greg Chin, KD Foundation
Other Stakeholder Partners
No information provided by awardee.