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Evidence summaries

Salicylate for the Treatment of Kawasaki Disease in Children

Salicylates may not be effective for the prevention of coronary artery lesions in children with Kawasaki disease. Level of evidence: "C"

The quality of evidence is downgraded by study limitations (unclear allocation concealment and lack of blinding) and by imprecise results (few patients and outcome events and wide confidence intervals).

Summary

A Cochrane review [Abstract] 1 included 1 study with a total of 102 subjects. There was no association between the addition of ASA to IVIG treatment on the rate of coronary artery abnormalities at follow up: prior to 30 days from onset of symptoms (RR 0.97, 95% CI 0.43 to 2.19) or at 30 days post onset of symptoms (RR 1.30, 95% CI 0.37 to 4.56).

Clinical comment: Current guidelines recommend the use of aspirin in Kawasaki disease. The American Heart Association 2 guideline states that administration of moderate- (30-50 mg/kg/day) to high-dose (80-100 mg/kg/day) aspirin is reasonable until the patient is afebrile, although there is no evidence that it reduces coronary artery aneurysms.

    References

    • Baumer JH, Love SJ, Gupta A, Haines LC, Maconochie I, Dua JS. Salicylate for the treatment of Kawasaki disease in children. Cochrane Database Syst Rev 2006;(4):CD004175 [Last assessed as up-to-date: 3 February 2009]. [PubMed]
    • McCrindle BW, Rowley AH, Newburger JW et al. Diagnosis, Treatment, and Long-Term Management of Kawasaki Disease: A Scientific Statement for Health Professionals From the American Heart Association. Circulation 2017;135(17):e927-e999. [PubMed]

Primary/Secondary Keywords