PMID- 32885390
OWN - NLM
STAT- MEDLINE
DCOM- 20210104
LR  - 20220218
IS  - 1179-2019 (Electronic)
IS  - 1174-5878 (Print)
IS  - 1174-5878 (Linking)
VI  - 22
IP  - 6
DP  - 2020 Dec
TI  - Anakinra for Treatment-Resistant Kawasaki Disease: Evidence from a Literature 
      Review.
PG  - 645-652
LID - 10.1007/s40272-020-00421-3 [doi]
AB  - Kawasaki disease (KD) is one of the most common vasculitides of childhood and the 
      main cause of acquired heart disease in developed countries. Intravenous 
      immunoglobulin (IVIG) in association with aspirin represents the main treatment 
      for KD. However, 10-20% of patients fail to respond to standard treatment and 
      have an increased risk of cardiac complications. There is currently no accepted 
      protocol for treatment of resistant cases. Several authors highlighted the role 
      of interleukin-1 (IL-1) as a mediator of inflammation in KD and suggested the 
      possibility of using IL-1 or its receptor as a target of therapy. The use of IL-1 
      inhibitors in patients with KD has been reported in the scientific literature, 
      but data are largely limited to individual case reports and small case series. We 
      summarized the scientific literature related to the use of anakinra, analyzing 
      preclinical and clinical data. Thirty-eight patients have been described so far, 
      most of them with KD-related complications. Twenty-two were described in case 
      reports and case series, while 16 were patients from the completed KAWAKINRA 
      phase IIa study. Almost all patients received clinical benefit, and no relevant 
      side effects were noted. Based on this evidence, in our opinion, anakinra may be 
      considered as an option after the failure of the first IVIG infusion, especially 
      in patients with coronary involvement.
FAU - Ferrara, Giovanna
AU  - Ferrara G
AD  - ASL Toscana Centro, Florence, Italy.
FAU - Giani, Teresa
AU  - Giani T
AUID- ORCID: 0000-0001-9292-7601
AD  - AOU Meyer, Florence, Italy. teresa.giani@mail.com.
AD  - Department of Medical Biotechnology, University of Siena, Siena, Italy. 
      teresa.giani@mail.com.
FAU - Caparello, Maria Costanza
AU  - Caparello MC
AD  - ASST G-Pini, Milan, Italy.
FAU - Farella, Carla
AU  - Farella C
AD  - AOU Meyer, Florence, Italy.
FAU - Gamalero, Lisa
AU  - Gamalero L
AD  - University of Udine, Udine, Italy.
FAU - Cimaz, Rolando
AU  - Cimaz R
AD  - ASST G-Pini, Milan, Italy.
AD  - Department of Clinical Sciences and Community Health and RECAP-RD, University of 
      Milan, Milan, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Switzerland
TA  - Paediatr Drugs
JT  - Paediatric drugs
JID - 100883685
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Interleukin 1 Receptor Antagonist Protein)
SB  - IM
MH  - Animals
MH  - Antirheumatic Agents/pharmacology/*therapeutic use
MH  - Drug Resistance/*drug effects
MH  - Female
MH  - Humans
MH  - Interleukin 1 Receptor Antagonist Protein/pharmacology/*therapeutic use
MH  - Male
MH  - Mice
MH  - Mucocutaneous Lymph Node Syndrome/*drug therapy
PMC - PMC7471561
COIS- There are no conflicts of interest. There are no competing interests.
EDAT- 2020/09/05 06:00
MHDA- 2021/01/05 06:00
PMCR- 2020/09/04
CRDT- 2020/09/05 06:00
PHST- 2020/09/05 06:00 [pubmed]
PHST- 2021/01/05 06:00 [medline]
PHST- 2020/09/05 06:00 [entrez]
PHST- 2020/09/04 00:00 [pmc-release]
AID - 10.1007/s40272-020-00421-3 [pii]
AID - 421 [pii]
AID - 10.1007/s40272-020-00421-3 [doi]
PST - ppublish
SO  - Paediatr Drugs. 2020 Dec;22(6):645-652. doi: 10.1007/s40272-020-00421-3.