What is the duration of treatment for Kawasaki disease?

From the Guidelines

The treatment duration for Kawasaki disease is typically 4-6 weeks.

Treatment Overview

The treatment consists of an initial phase of intravenous immunoglobulin (IVIG) at a dose of 2 grams per kilogram, administered over 12 hours, in conjunction with high-dose aspirin at 80-100 mg/kg/day, divided into four doses 1.

• Aspirin is continued at a lower anti-inflammatory dose of 30-50 mg/kg/day for an additional 2-3 weeks, until the patient is afebrile and inflammatory markers have normalized.
• In patients who do not respond to initial IVIG treatment, a second dose of 2 grams per kilogram may be administered, and in some cases, additional treatments such as corticosteroids or infliximab may be considered 1.

Ongoing Monitoring

The total treatment duration is typically 4-6 weeks, with ongoing monitoring for coronary artery aneurysms and other potential complications 1.

• The use of corticosteroids, such as intravenous methylprednisolone, may be considered in patients who do not respond to initial IVIG treatment, although the effects on coronary artery abnormalities are still uncertain 1.
• The American Heart Association recommends that steroid treatment be restricted to children in whom 2 infusions of IVIG have been ineffective in alleviating fever and acute inflammation 1.

From the Research

Duration of Treatment for Kawasaki Disease

The duration of treatment for Kawasaki disease is not explicitly stated in the provided studies. However, the treatment options and their durations can be inferred from the following points:

• The standard initial therapy for Kawasaki disease is intravenous immunoglobulin (IVIG) and aspirin, with the goal of improving clinical outcomes and reducing the risk of coronary artery complications 2.
• The duration of IVIG therapy is typically a single dose, but some patients may require additional doses if they do not respond to the initial treatment 3, 4.
• The duration of aspirin therapy varies, but it is often used in conjunction with IVIG and may be continued for several days or weeks 2, 5.
• For patients who do not respond to initial IVIG therapy, additional treatments such as infliximab or a second dose of IVIG may be considered, with the goal of resolving fever and reducing inflammation 6.

Key Findings

• The efficacy of IVIG in preventing coronary artery abnormalities (CAAs) is well established, with high-dose regimens showing improved outcomes compared to lower-dose regimens 4.
• The duration of fever and hospital stay may be reduced with the use of high-dose IVIG regimens or alternative treatments such as infliximab 4, 6.
• The use of aspirin in conjunction with IVIG may not affect long-term coronary artery outcomes, and the duration of aspirin therapy does not appear to impact the risk of CAAs 5.

Treatment Options

• IVIG: typically a single dose, but may be repeated if necessary
• Aspirin: duration varies, but often used in conjunction with IVIG
• Infliximab: may be considered for patients who do not respond to initial IVIG therapy
• Corticosteroids: may be used in addition to IVIG and aspirin, particularly for patients at high risk of developing adverse coronary artery outcomes 2