Five-Year Experience of Etanercept as Adjunct to Intravenous Immunoglobulin for Kawasaki Disease with Coronary Artery Involvement
Year: 2025
Type: article
Abstract: ABSTRACT: Objective The Etanercept as Adjunctive Treatment for Acute Kawasaki Disease (EATAK) trial was a phase 3, placebo-controlled, randomized trial that evaluated etanercept use for acute Kawasaki Disease (KD). Trial data suggest improved coronary artery aneurysm metrics with etanercept compared to placebo. This report summarizes a single center continued experience with etanercept for KD presenting with coronary artery aneurysms (z-score ≥ 2.5). Study Design Etanercept at 3 weekly doses, first given as adjuvant to Intravenous Immunoglobulin (IVIg), is given to all children admitted with acute KD and coronary artery aneurysm(s). Chart review was performed for 37 children who received at least 1 dose of etanercept for this indication to evaluate for side effects, compliance and coronary artery outcomes. Results Of 37 children, 95% and 92% completed a 2 nd and 3 rd dose of etanercept as outpatient. No serious adverse events were observed. Of the 30 children with mild or moderate coronary artery dilation (z-score ≥ 2.5 but < 10), 77% regressed to z-score < 2.5 by 6 weeks and 97% by 2 years. In 7 children that presented with giant aneurysm(s) (z-score ≥ 10), 71% and 86% regressed to a z-score < 10 at 6 weeks and 6 months, respectively, allowing discontinuation of anticoagulation. Conclusions Etanercept as intensification therapy for KD with coronary artery aneurysms can be delivered safely and with good compliance. This report suggests benefit in preventing long-term persistence of severe and any coronary artery disease.
Institution: Seattle Children's Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,050
OpenAlex ID: W4412465339