국내 가와사키병 환아의 약물사용
Drug Utilization in Korean Children with Kawasaki Disease
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Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease inchildren. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purposeof 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 theHealth 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 orDecember. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications wereinvestigated between “IVIG + high-dose aspirin” group and “IVIG + moderate-dose aspirin” group. Results: In acute phase, IVIGwas administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with highdoseaspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complicationsoccurred less in “IVIG + high-dose aspirin” group compared to “IVIG + moderate-dose aspirin” group, but not statisticallysignificant (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 andfurther research is warranted.
Abstract
Background: Kawasaki disease (KD) is an acute febrile, systemic vasculitis as a leading cause of acquired heart disease inchildren. Intravenous immunoglobulin G (IVIG) and aspirin are the standard initial therapy in the treatment of acute KD. The purposeof 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 theHealth 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 orDecember. Drug utilization pattern were assessed in acute KD patients and 30-day and 60-day cardiac complications wereinvestigated between “IVIG + high-dose aspirin” group and “IVIG + moderate-dose aspirin” group. Results: In acute phase, IVIGwas administered to 95.8% patients, and 57.1% patients were prescribed moderate-dose aspirin and 25% patients were with highdoseaspirin. Steroid use was rapidly increased from 4.0% in 2010 to 11.3% in 2015. Both 30-day and 60-day cardiac complicationsoccurred less in “IVIG + high-dose aspirin” group compared to “IVIG + moderate-dose aspirin” group, but not statisticallysignificant (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 andfurther research is warranted.
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