https://scholars.lib.ntu.edu.tw/handle/123456789/376460
標題: | Comparative Effectiveness of Intravenous Immunoglobulin for Children with Kawasaki Disease: A Nationwide Cohort Study | 作者: | Lin, Ming-Chih Fu, Yun-Ching Jan, Sheng-Ling Lai, Mei-Shu |
公開日期: | 2013 | 卷: | 8 | 期: | 5 | 來源出版物: | PLoS ONE | 摘要: | Introduction:Different immunoglobulin manufacturing processes may influence its effectiveness for Kawasaki disease. However, nationwide studies with longitudinal follow-up are still lacking. The aim of this study was to evaluate the comparative effectiveness of immunoglobulin preparations from a nationwide perspective.Materials and Methods:This is a nationwide retrospective cohort study with a new user design. Data came from the National Health Insurance Research Database of Taiwan. From 1997 to 2008, children under 2 years old who received immunoglobulin therapy for the first time under the main diagnosis of Kawasaki disease were enrolled. The manufacturing processes were divided into β-propiolactonation, acidification and those containing IgA. The endpoints were immunoglobulin non-responsiveness, acute aneurysm, prolonged use of anti-platelets or anti-coagulants, and recurrence.Results:In total, 3830 children were enrolled. β-propiolactonation had a relative risk of 1.45 (95% CI 1.08?1.94) of immunoglobulin non-responsiveness, however, the relative risks for acidification and containing IgA were non-significant. For acute aneurysms, acidification had a relative risk of 1.49 (95% CI 1.17?1.90), however the relative risks for β-propiolactonation and containing IgA were non-significant. For prolonged use of anti-platelets or anti-coagulants, β-propiolactonation had a relative risk of 1.44 (95% CI 1.18?1.76), and acidification protected against them both with a relative risk of 0.82 (95% CI 0.69?0.97), whereas the relative risk for containing IgA was non-significant. For recurrence, all three factors were non-significant.Conclusions:The effectiveness of immunoglobulin may differ among different manufacturing processes. β-propiolactonation had a higher risk of treatment failure and prolonged use of anti-platelets or anti-coagulants. Acidification may increase the risk of acute coronary aneurysms. ? 2013 Lin et al. |
URI: | http://www.scopus.com/inward/record.url?eid=2-s2.0-84877019238&partnerID=MN8TOARS http://scholars.lib.ntu.edu.tw/handle/123456789/376460 |
DOI: | 10.1371/journal.pone.0063399 | SDG/關鍵字: | anticoagulant agent; antithrombocytic agent; immunoglobulin; immunoglobulin A; immunoglobulin G; immunoglobulin; acidification; article; child; cohort analysis; comparative effectiveness; controlled study; coronary artery aneurysm; drug efficacy; drug response; drug treatment failure; female; human; immunotherapy; long term care; major clinical study; male; mucocutaneous lymph node syndrome; preschool child; recurrence risk; retrospective study; comparative study; disease free survival; drug formulation; infant; Kaplan Meier method; mucocutaneous lymph node syndrome; risk; sensitivity and specificity; treatment failure; Disease-Free Survival; Drug Compounding; Female; Humans; Immunoglobulins, Intravenous; Infant; Kaplan-Meier Estimate; Male; Mucocutaneous Lymph Node Syndrome; Odds Ratio; Retrospective Studies; Sensitivity and Specificity; Treatment Failure |
顯示於: | 流行病學與預防醫學研究所 |
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