TY - JOUR
T1 - Low-dose or no aspirin administration in acute-phase Kawasaki disease
T2 - A meta-analysis and systematic review
AU - Chiang, Ming Hsiu
AU - Liu, Hsingjin Eugene
AU - Wang, Jinn Li
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Objective: To compare the efficacy of low-dose or no aspirin with conventional high-dose aspirin for the initial treatment in the acute-phase of Kawasaki disease (KD). Design: A meta-analysis and systematic review of randomised control trials and cohort studies. Methods: All available articles that compared different dosage of aspirin in the acute-phase of KD published until 20 September 2019 were included from the databases of PubMed, Embase and Cochrane Central Register of Controlled Trials Central without language restrictions. Extracted data from eligible studies were reviewed by two authors independently and analysed by using RStudio software. Results: Nine cohorts with a total of 12 182 children were enrolled. We found that low-dose (3-5 mg/kg/day) or no aspirin in the acute-phase KD was associated with reducing the risk of coronary artery lesions (CALs, OR=0.81, 95% CI 0.69 to 0.95). No differences were observed in intravenous immunoglobulin resistance, length of hospital stay and fever days after admission (OR=1.35, 95% CI 0.91 to 1.98; standard mean difference (SMD)=0.17, 95% CI -1.07 to 1.4; SMD=0.3, 95% CI -1.51 to 2.11) in the low-dose/no aspirin subgroup compared with the high-dose (≥30 mg/kg/day) aspirin subgroup. We did not identify any potential factors affecting the homogeneity of CAL risk as well as clinical important effects in all included studies. Conclusions: Prescribing low-dose or no aspirin in the acute-phase of KD might be associated with a decreased incidence of CAL. However, additional well-designed prospective trials are required to support the theory.
AB - Objective: To compare the efficacy of low-dose or no aspirin with conventional high-dose aspirin for the initial treatment in the acute-phase of Kawasaki disease (KD). Design: A meta-analysis and systematic review of randomised control trials and cohort studies. Methods: All available articles that compared different dosage of aspirin in the acute-phase of KD published until 20 September 2019 were included from the databases of PubMed, Embase and Cochrane Central Register of Controlled Trials Central without language restrictions. Extracted data from eligible studies were reviewed by two authors independently and analysed by using RStudio software. Results: Nine cohorts with a total of 12 182 children were enrolled. We found that low-dose (3-5 mg/kg/day) or no aspirin in the acute-phase KD was associated with reducing the risk of coronary artery lesions (CALs, OR=0.81, 95% CI 0.69 to 0.95). No differences were observed in intravenous immunoglobulin resistance, length of hospital stay and fever days after admission (OR=1.35, 95% CI 0.91 to 1.98; standard mean difference (SMD)=0.17, 95% CI -1.07 to 1.4; SMD=0.3, 95% CI -1.51 to 2.11) in the low-dose/no aspirin subgroup compared with the high-dose (≥30 mg/kg/day) aspirin subgroup. We did not identify any potential factors affecting the homogeneity of CAL risk as well as clinical important effects in all included studies. Conclusions: Prescribing low-dose or no aspirin in the acute-phase of KD might be associated with a decreased incidence of CAL. However, additional well-designed prospective trials are required to support the theory.
KW - cardiology
KW - outcomes research
KW - vascular disease
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U2 - 10.1136/archdischild-2019-318245
DO - 10.1136/archdischild-2019-318245
M3 - Article
C2 - 33172886
AN - SCOPUS:85096067411
SN - 0003-9888
VL - 106
SP - 662
EP - 668
JO - Archives of Disease in Childhood
JF - Archives of Disease in Childhood
IS - 7
M1 - 2019318245
ER -