PMID- 31117119 OWN - NLM STAT- MEDLINE DCOM- 20200203 LR - 20200309 IS - 1932-6203 (Electronic) IS - 1932-6203 (Linking) VI - 14 IP - 5 DP - 2019 TI - Efficacy between low and high dose aspirin for the initial treatment of Kawasaki disease: Current evidence based on a meta-analysis. PG - e0217274 LID - 10.1371/journal.pone.0217274 [doi] LID - e0217274 AB - BACKGROUND: Kawasaki disease (KD) is now the leading cause of acquired heart disease in children in developed countries. Intravenous immunoglobulin (IVIG) and aspirin were considered as the standard initial treatment of KD for decades. However, the optimal dose of aspirin has remained controversial. In recent years, many studies compared the efficacy of low-dose with high-dose aspirin in the acute phase of KD, but the results have not always been consistent. Therefore, we performed this meta-analysis to evaluate the efficacy of low-dose aspirin compared with high-dose for the initial treatment of KD. METHODS: Studies related to aspirin therapy for KD were selected from PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Google scholar through Mar 25th, 2019. Data were analyzed using STATA Version 15.1. Additionally, publication bias and sensitivity analysis were also performed by STATA version 15.1. RESULTS: Six studies were included in our analysis of the rate of coronary artery lesion (CAL), five reports for IVIG-resistant KD (rKD), and four for the duration of fever and hospitalization. However, no significant differences were found between low-dose and high-dose aspirin groups in the incidence of CAL (risk ratio (RR), 0.85; 95%CI (0.63, 1.14); P = 0.28), the risk of rKD (RR, 1.39; 95%CI (1.00, 1.93); P = 0.05), and duration of fever and hospitalization (the mean standard deviation (SMD), 0.03; 95%CI (-0.16, 0.22); P = 0.78). CONCLUSION: Low-dose aspirin (3-5 mg.kg-1.d-1) may be as effective as the use of high-dose aspirin (>/=30 mg.kg-1.d-1) for the initial treatment of KD. Further well-designed randomized clinical trials are needed to evaluate the efficacy of low-dose aspirin for the initial treatment of KD. FAU - Zheng, Xiaolan AU - Zheng X AUID- ORCID: 0000-0001-5971-4284 AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - West China Medical School, Sichuan University, Chengdu, Sichuan, China. FAU - Yue, Peng AU - Yue P AUID- ORCID: 0000-0002-8541-0265 AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - West China Medical School, Sichuan University, Chengdu, Sichuan, China. FAU - Liu, Lei AU - Liu L AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - West China Medical School, Sichuan University, Chengdu, Sichuan, China. FAU - Tang, Changqing AU - Tang C AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - West China Medical School, Sichuan University, Chengdu, Sichuan, China. FAU - Ma, Fan AU - Ma F AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - West China Medical School, Sichuan University, Chengdu, Sichuan, China. FAU - Zhang, Yi AU - Zhang Y AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Wang, Chuan AU - Wang C AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Duan, Hongyu AU - Duan H AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Zhou, Kaiyu AU - Zhou K AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Program for Changjiang Scholars and Innovative Research Team in University, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Hua, Yimin AU - Hua Y AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Program for Changjiang Scholars and Innovative Research Team in University, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Wu, Gang AU - Wu G AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. FAU - Li, Yifei AU - Li Y AUID- ORCID: 0000-0002-3096-4287 AD - Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. AD - Ministry of Education Key Laboratory of Women and Children's Diseases and Birth Defects, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't DEP - 20190522 PL - United States TA - PLoS One JT - PloS one JID - 101285081 RN - 0 (Anti-Inflammatory Agents, Non-Steroidal) RN - 0 (Immunoglobulins, Intravenous) RN - R16CO5Y76E (Aspirin) SB - IM MH - Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/adverse effects MH - Aspirin/*administration & dosage/adverse effects MH - Child, Preschool MH - Coronary Aneurysm/etiology/prevention & control MH - Dose-Response Relationship, Drug MH - Humans MH - Immunoglobulins, Intravenous/administration & dosage MH - Mucocutaneous Lymph Node Syndrome/complications/*drug therapy MH - Treatment Outcome PMC - PMC6531010 COIS- The authors have declared that no competing interests exist. EDAT- 2019/05/23 06:00 MHDA- 2020/02/06 06:00 PMCR- 2019/05/22 CRDT- 2019/05/23 06:00 PHST- 2018/08/15 00:00 [received] PHST- 2019/05/09 00:00 [accepted] PHST- 2019/05/23 06:00 [entrez] PHST- 2019/05/23 06:00 [pubmed] PHST- 2020/02/06 06:00 [medline] PHST- 2019/05/22 00:00 [pmc-release] AID - PONE-D-18-23975 [pii] AID - 10.1371/journal.pone.0217274 [doi] PST - epublish SO - PLoS One. 2019 May 22;14(5):e0217274. doi: 10.1371/journal.pone.0217274. eCollection 2019.