Efficacy of Immunoglobulin Plus Prednisolone in Reducing Coronary Artery Lesion in Patients With Kawasaki Disease

NCT ID: NCT04078568

Last Updated: 2025-12-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

3208 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-15

Study Completion Date

2025-12-31

Brief Summary

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This study evaluates the efficacy of the addition of prednisolone to conventional initial treatment (intravenous immunoglobulin \[IVIG\] plus aspirin) in reducing coronary artery lesion in children with Kawasaki disease (KD) .

Detailed Description

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This is a multicenter, open-label, blind-endpoints, randomized controlled trial at more than 10 hospitals in China. The investigators enrolled KD children diagnosed within 10 days of onset. Participants will be randomly assigned in a 1:1 ratio to the control group (receiving 2g/kg IVIG and 30 mg/kg aspirin) or the intervention group (receiving 2 g/kg IVIG, 30 mg/kg aspirin and additional 2 mg/kg prednisolone). Baseline characteristics of each participant will be collected, including sex, age of onset, height, body weight, subtype of KD, fever days before initial IVIG, echocardiographic findings at enrolment, and a series of pre-IVIG laboratory tests. Two-dimensional echocardiography will be performed at admission, 2 weeks, 1 month, 3 months, 6 months,and 12 months after onset of KD to assess the coronary artery lesions.

Conditions

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Kawasaki Disease

Keywords

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Kawasaki disease prednisolone coronary artery lesion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Participants and physicians will not be masked to the assignment. Pediatric cardiologists who assess coronary artery lesions (CAL) by echocardiography will be masked to the allocation.

Study Groups

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the standard group

1. IVIG 2g/kg once, given within 12 to 24 hours;
2. Aspirin 30 mg/kg in oral per day (given in 3 divided doses), then 3 to 5 mg/kg per day when fever subsides for 3 days and C-reactive protein (CRP) is normal. Aspirin will be continued for at least 6 weeks after onset of illness.

Group Type ACTIVE_COMPARATOR

IVIG

Intervention Type DRUG

IVIG at a single dose of 2 g/kg, with the maximum dose of 60g

Aspirin

Intervention Type DRUG

Aspirin 30 mg/kg in oral per day (given in 3 divided doses), then 3 to 5 mg/kg per day when fever subsides for 3 days and C-reactive protein (CRP) is normal. Aspirin will be continued for at least 6 weeks after onset of illness.

the standard+prednisolone group

1. IVIG 2g/kg once, given within 12 to 24 hours;
2. Aspirin 30 mg/kg in oral per day (given in 3 divided doses), then 3 to 5 mg/kg per day when fever subsides for 3 days and CRP is normal. Aspirin will be continued for at least 6 weeks after onset of illness.
3. Intravenous methylprednisolone 1.6 mg/kg per day (given in 2 divided doses) for 3 days, which is administered concurrently with the initial IVIG infusion and completed within 30-60 minutes, then changed to oral prednisolone 2 mg/kg when fever subsides for 3 days . If CRP is normal, the oral dose will be reduced every 5 days from 2 mg/kg to 1 mg/kg to 0.5 mg/kg (tapered over 15 days). Then prednisolone will be discontinued.

Group Type EXPERIMENTAL

IVIG

Intervention Type DRUG

IVIG at a single dose of 2 g/kg, with the maximum dose of 60g

Aspirin

Intervention Type DRUG

Aspirin 30 mg/kg in oral per day (given in 3 divided doses), then 3 to 5 mg/kg per day when fever subsides for 3 days and C-reactive protein (CRP) is normal. Aspirin will be continued for at least 6 weeks after onset of illness.

Prednisolone

Intervention Type DRUG

Intravenous methylprednisolone 1.6 mg/kg per day (given in 2 divided doses, with the maximum dose 60mg of prednisolone ) for 3 days, which is administered concurrently with the initial IVIG infusion and completed within 30-60 minutes, then changed to oral prednisolone 2 mg/kg when fever subsides for 3 days. If CRP is normal, the oral dose will be reduced every 5 days from 2 mg/kg to 1 mg/kg to 0.5 mg/kg (tapered over 15 days). Then prednisolone will be discontinued.

Interventions

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IVIG

IVIG at a single dose of 2 g/kg, with the maximum dose of 60g

Intervention Type DRUG

Aspirin

Aspirin 30 mg/kg in oral per day (given in 3 divided doses), then 3 to 5 mg/kg per day when fever subsides for 3 days and C-reactive protein (CRP) is normal. Aspirin will be continued for at least 6 weeks after onset of illness.

Intervention Type DRUG

Prednisolone

Intravenous methylprednisolone 1.6 mg/kg per day (given in 2 divided doses, with the maximum dose 60mg of prednisolone ) for 3 days, which is administered concurrently with the initial IVIG infusion and completed within 30-60 minutes, then changed to oral prednisolone 2 mg/kg when fever subsides for 3 days. If CRP is normal, the oral dose will be reduced every 5 days from 2 mg/kg to 1 mg/kg to 0.5 mg/kg (tapered over 15 days). Then prednisolone will be discontinued.

Intervention Type DRUG

Other Intervention Names

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Intravenous Immunoglobulins, Human Acetylsalicylic acid STEROLONE

Eligibility Criteria

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Inclusion Criteria

* Meeting diagnostic criteria for Kawasaki disease (KD) released by American Heart Association (AHA) in 2017
* Diagnosed before the tenth day of illness (with the first day of illness defined as the first day of fever)
* Not treated with IVIG yet
* Age ≥1 month

Exclusion Criteria

* Z score of any coronary artery before initial treatment ≥10
* Receiving steroids or other immunosuppressive agents in the previous 30 days
* With a previous history of KD
* Afebrile before enrolment
* With suspected infectious diseases including sepsis, septic meningitis, peritonitis, bacterial pneumonia, varicella and influenza
* With serious immune diseases such as immunodeficiency or chromosomal abnormalities
Minimum Eligible Age

1 Month

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Jiangxi Province Children's Hospital

OTHER

Sponsor Role collaborator

First People's Hospital of Hangzhou

OTHER

Sponsor Role collaborator

Shengjing Hospital

OTHER

Sponsor Role collaborator

The First Hospital of Jilin University

OTHER

Sponsor Role collaborator

Chengdu Women's and Children's Central Hospital

OTHER

Sponsor Role collaborator

Children's Hospital of Chongqing Medical University

OTHER

Sponsor Role collaborator

Inner Mongolia People's Hospital

OTHER

Sponsor Role collaborator

Sichuan Provincial People's Hospital

OTHER

Sponsor Role collaborator

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

OTHER

Sponsor Role collaborator

Third Affiliated Hospital of Zhengzhou University

OTHER

Sponsor Role collaborator

Children's Hospital of Soochow University

OTHER

Sponsor Role collaborator

Yuying Children's Hospital of Wenzhou Medical University

OTHER

Sponsor Role collaborator

Beijing Children's Hospital

OTHER

Sponsor Role collaborator

Qilu Hospital of Shandong University

OTHER

Sponsor Role collaborator

Children's Hospital of Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fang Liu, MD.

Role: STUDY_DIRECTOR

Children's Hospital of Fudan University

Locations

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Bengbu First People's Hopital

Bengbu, Anhui, China

Site Status

Anhui Children's Hospital

Hefei, Anhui, China

Site Status

Children's Hospital, Capital Institute of Pediatrics

Beijing, Beijing Municipality, China

Site Status

Children's Hospital of Chongqing Medical University

Chongqing, Chongqing Municipality, China

Site Status

Xiamen Children's Hospital

Xiamen, Fujian, China

Site Status

Lanzhou University Second Hospital

Lanzhou, Gansu, China

Site Status

Sun Yat-sen Memorial Hospital

Guangzhou, Guangdong, China

Site Status

Guangzhou Women and Children's Medical Center

Guangzhou, Guangdong, China

Site Status

Shenzhen Children's Hospital

Shenzhen, Guangdong, China

Site Status

Liuzhou Maternity and Children Healthcare Hospital

Liuchow, Guangxi, China

Site Status

Kaifeng Children's Hospital

Kaifeng, Henan, China

Site Status

Henan Children's Hospital

Zhengzhou, Henan, China

Site Status

the First Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, China

Site Status

The Third Affiliated Hospital of Zhengzhou University

Zhengzhou, Henan, China

Site Status

Taihe Hospital Affiliated Hospital of Hubei University of Medicine

Shiyan, Hubei, China

Site Status

Union Hospital,Tongji Medical College of Huazhong University of Science and Technology

Wuhan, Hubei, China

Site Status

Hunan Provincial People's Hospital

Changsha, Hunan, China

Site Status

Inner Mongolia People's Hospital

Hohhot, Inner Mongolia, China

Site Status

Children's Hospital of Nanjing Medical University

Nanjing, Jiangsu, China

Site Status

Children's hospital of Soochow University

Suzhou, Jiangsu, China

Site Status

Xuzhou Children's Hospital

Xuzhou, Jiangsu, China

Site Status

Jiangxi Provincial Children's Hospital

Nanchang, Jiangxi, China

Site Status

The First Hospital of Jilin University

Changchun, Jilin, China

Site Status

Shengjing Hospital of China Medical University

Shenyang, Liaoning, China

Site Status

Xi'an Children's Hospital

Xi'an, Shaanxi, China

Site Status

Qilu Hospital of Shandong University

Jinan, Shandong, China

Site Status

Qingdao Women and Children's Hospital (Liaoyang West Road)

Qingdao, Shandong, China

Site Status

Qingdao Women and Children's Hospital

Qingdao, Shandong, China

Site Status

Shanghai Children's Hospital

Shanghai, Shanghai Municipality, China

Site Status

Children's Hospital of Fudan University

Shanghai, Shanghai Municipality, China

Site Status

Sichuan Provincial People's Hospital

Chengdu, Sichuan, China

Site Status

Chengdu Women's and Children's Central Hospital

Chengdu, Sichuan, China

Site Status

Hangzhou First people's Hospital

Hangzhou, Zhejiang, China

Site Status

Yuying Children's Hospital of Wenzhou Medical University

Wenzhou, Zhejiang, China

Site Status

Countries

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China

References

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Lin SY, He L, Xie LP, Wang Y, Lin YX, Cao YY, Yan WL, Liu F, Huang GY. Effects of immunoglobulin plus prednisolone in reducing coronary artery lesions in patients with Kawasaki disease: study protocol for a phase III multicenter, open-label, blinded-endpoints randomized controlled trial. Trials. 2021 Dec 11;22(1):898. doi: 10.1186/s13063-021-05807-3.

Reference Type DERIVED
PMID: 34895290 (View on PubMed)

Provided Documents

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Document Type: Informed Consent Form: Informed Consent Form

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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KD-3-01

Identifier Type: -

Identifier Source: org_study_id