Objective: To assess the therapeutic effects and safety of different doses of immunoglobulin in the treatment of Kawasaki disease.
Methods: The papers related to the treatment of Kawasaki disease were electronically searched in the databases of PubMed, EMBASE, Cochrane Library, CNKI, VIP and Wanfang. Randomized clinical trials (RCT) on the treatment of Kawasaki disease with different doses of immunoglobulin were included and assessed for quality. A Mata analysis was performed by RevMan 5.0.
Results: Twenty-eight RCTs involved 2596 cases were included. The results of Meta analysis showed that there were no significant differences in the incidences of coronary artery injuries at various phases, adverse effects and fever disappearance time between the immunoglobulin treatment groups at the doses of 1 g/(kg•d) for 1-2 days and 2 g/(kg•d) for single use. The fever disappearance time in the immunoglobulin treatment group at the dose of 1 g/(kg•d) for 1-2 days was significantly shorter than that in the immunoglobulin treatment group at the dose of 400 mg/(kg•d) for 4-5 days, but there were no significant differences in the incidences of coronary artery injuries at the acute phase and 6 months after treatment and adverse effects between the two groups. The incidence of coronary artery injuries at the acute phase and 6 months was lower and the fever disappearance time was shorter in the immunoglobulin treatment group at the dose of 2 g/(kg•d) for single use than those in the immunoglobulin treatment group at the dose of 400 mg/(kg•d) for 4-5 days, but there were no significant differences in the incidences of coronary artery injuries at the subacute phase and 12 months after treatment and adverse effects between the two groups.
Conclusions: There are similar therapeutic effects for Kawasaki disease between the immunoglobulin treatment groups at the doses of 1 g/(kg•d) for 1-2 days and 2 g/(kg•d) for single use. The fever disappearance time in the two groups is shorter than that in the treatment group at the dose of 400 mg /(kg•d) for 4-5 days.