Korean J Clin Pharm.  2017 Sep;27(3):127-135. 10.24304/kjcp.2017.27.3.127.

Drug Utilization in Korean Children with Kawasaki Disease

• Cha S
• Je NK

• KMID: 2405666
• DOI: http://doi.org/10.24304/kjcp.2017.27.3.127

Abstract

BACKGROUND
Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease in children. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purpose of this study was to investigate drug utilization in children with KD, and to compare "IVIG + high-dose aspirin" and "IVIG + moderate-dose aspirin" in preventing cardiac complications.
METHODS
We analyzed pediatric patient sample data compiled by the Health Insurance Review & Assessment Service from 2010 to 2015. We identified patients with KD using the KCD-6 code of M30.3. We excluded patients in chronic phase or ≥10 years. We also excluded patients who were diagnosed KD in November or December. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications were investigated between "IVIG + high-dose aspirin" group and "IVIG + moderate-dose aspirin" group.
RESULTS
In acute phase, IVIG was administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with highdose aspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complications occurred less in "IVIG + high-dose aspirin" group compared to "IVIG + moderate-dose aspirin" group, but not statistically significant (0.9% vs 1.8%, p=0.252 for 30-day complication rate; 1.5% vs 2.7%. p=0.073 for 60-day complication rate).
CONCLUSION
We were not able to demonstrate which aspirin therapy is superior for preventing cardiac complications in acute KD patients and further research is warranted.

Keyword

Acute kawasaki disease; drug utilization; intravenous immunoglobulin G; aspirin; complication rate

MeSH Terms

Aspirin
Child*
Drug Utilization*
Heart Diseases
Humans
Immunoglobulin G
Immunoglobulins, Intravenous
Insurance, Health
Mucocutaneous Lymph Node Syndrome*
Systemic Vasculitis
Aspirin
Immunoglobulin G
Immunoglobulins, Intravenous