| Objective To evaluate the efficacy and safety of infliximab used for treatment in children with Kawasaki disease.Methods Extensive search of Pubmed,EMBASE,Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Wanfang Date,VIP Database and China Biology Medicine disc(CBMdisc)was done.Randomized controlled trials(RCT)were included in this article to evaluate the role of infliximab in Kawasaki disease.Studies were screened and data from the included studies were extracted by two of the authors.Each disagreement had been solved by the senior author.Through the Review Manager 5.2 software,the Cochrane Collaboration's tool for assessing risk of bias was used to assess the quality of every study.The result of the incidence of treatment resistance,incidence of coronary artery abnormalities(CAA)and number of adverse events was analyzed in the literature.The odds ratio was estimated with a 95%confidence interval in a fixed effects model.If the study had high heterogeneity,the model of data analysis was replaced by random effect mode.Otherwise,the model of data analysis was not changed.If there was a significant heterogeneity on clinical manifestation,sensitivity analysis could be chosen.Results Five trials were included with a total of 448 participants.A significant decrease in the incidence of treatment resistance was found with infliximab when compared to control group(OR0.43,95%CI:0.25-0.76,P=0.004,I~2=27%).However,there was no significant difference in the over-all incidence of coronary artery abnormalities(OR0.86,95%CI:0.55-1.36,P=0.53,I~2=0%)and the number of adverse events(OR0.70,95%CI:0.41-1.18,P=0.18,I~2=0%)between infliximab and control group.Conclusions Infliximab is effective in Kawasaki disease with decreased incidence of treatment resistance.And we concluded that infliximab is safe for Kawasaki disease in children according to current evidence.More studies are needed to determine the effect of infliximab on coronary artery aneurysms. |
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