AEPC-YIA session（III-AEPCYIA）

[III-AEPCYIA-03] Low- versus high-concentration intravenous immunoglobulin for children with Kawasaki disease in the acute phase

^○Takanori Suzuki¹, Nobuaki Michihata², Tetsushi Yoshikawa¹, Kazuyoshi Saito¹, Hiroki Matsui³, Kiyohide Fushimi⁴, Hideo Yasunaga³ (1.Department of Pediatrics, Fujita Health University, 2.Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 3.Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, 4.Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine)

キーワード：川崎病, IVIG, 10％製剤

Purpose: Few studies have compared the effects of low-concentration (5%) and high-concentration (10%) intravenous immunoglobulin (IVIG) preparations for patients with Kawasaki disease (KD) in the acute phase. The purpose of this study was to compare outcomes between low-and high-concentration IVIG preparations in children with KD, using a national inpatient database in Japan.Method: We used the Diagnostic Procedure Combination database to identify patients with KD treated with IVIG from April 2012 to March 2020. We identified those receiving high-and low-concentration IVIG preparations as an initial treatment. Propensity score-matched analyses were conducted to compare the outcomes between the 2 groups. Instrumental variable analyses were performed to confirm the results.Result: We identified 48 046 patients with KD and created 4:1 propensity score-matched pairs between the low-and high-concentration IVIG groups. There was a significant difference in the percentage with IVIG resistance between the 2 groups (20.6% vs 24.1%; risk difference, 3.5% [95% confidence interval, 2.3-4.7];P = .001). However, there was no significant difference in CAAs (1.6% vs 1.6%; risk difference,0.013% [95% confidence interval, - 0.34 to 0.37]; P = .953). The instrumental variable analyses showed similar results.Conclusions: The proportion of CAAs did not differ significantly between those receiving low-andhigh-concentration IVIG. To confirm the results of this study, prospective studies adjusting for duration of IVIG administration and duration of observation are needed.