Effectiveness of antiplatelet therapy for Kawasaki disease: a systematic review

Kawasaki disease is an acute systemic vasculitis in children. Antiplatelet medicines are commonly used for Kawasaki disease to attenuate vasculitis and prevent thromboembolism; however, the mechanisms have not been elucidated. The objective of this study is to assess the effectiveness of antiplatele...

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Veröffentlicht in:European journal of pediatrics 2019-06, Vol.178 (6), p.947-955
Hauptverfasser: Tanoshima, Reo, Hashimoto, Risa, Suzuki, Takanori, Ishiguro, Akira, Kobayashi, Tohru
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container_issue 6
container_start_page 947
container_title European journal of pediatrics
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creator Tanoshima, Reo
Hashimoto, Risa
Suzuki, Takanori
Ishiguro, Akira
Kobayashi, Tohru
description Kawasaki disease is an acute systemic vasculitis in children. Antiplatelet medicines are commonly used for Kawasaki disease to attenuate vasculitis and prevent thromboembolism; however, the mechanisms have not been elucidated. The objective of this study is to assess the effectiveness of antiplatelet medications for Kawasaki disease. We used Medline, Embase, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Ichushi) from January 1947 to August 2018. Studies describing the platelet functions of antiplatelet drugs for Kawasaki disease were included. Twenty studies met the inclusion criteria. There were no randomized controlled trials. Seven studies compared platelet aggregation ability before and after treatment. Eight studies compared platelet aggregation with that in Kawasaki disease patients without treatment. Four studies compared aggregation among different types of antiplatelet drugs or at different doses. Antiplatelet medications administered in the studies included aspirin, flurbiprofen, dipyridamole, and choline salicylate. Methods for the measurement of platelet aggregation ability varied among studies. The groups with antiplatelet treatment tended to have a decreased platelet aggregation function. The statistical analyses were impossible due to insufficient quantitative data and heterogeneity among the studies. Conclusion : The present systematic review revealed that there was insufficient evidence for the effectiveness of antiplatelet therapy for Kawasaki disease. What is Known: • Antiplatelet therapy is widely used for Kawasaki disease to mitigate cardiac complications . • The mechanisms of antiplatelet therapy for Kawasaki disease are not clarified . What is New: • This systematic review showed that the groups with antiplatelet treatment tended to have a decreased platelet aggregation function . • There is insufficient evidence for the effectiveness of antiplatelet therapy for Kawasaki disease .
doi_str_mv 10.1007/s00431-019-03368-x
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Antiplatelet medications administered in the studies included aspirin, flurbiprofen, dipyridamole, and choline salicylate. Methods for the measurement of platelet aggregation ability varied among studies. The groups with antiplatelet treatment tended to have a decreased platelet aggregation function. The statistical analyses were impossible due to insufficient quantitative data and heterogeneity among the studies. Conclusion : The present systematic review revealed that there was insufficient evidence for the effectiveness of antiplatelet therapy for Kawasaki disease. What is Known: • Antiplatelet therapy is widely used for Kawasaki disease to mitigate cardiac complications . • The mechanisms of antiplatelet therapy for Kawasaki disease are not clarified . 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Antiplatelet medicines are commonly used for Kawasaki disease to attenuate vasculitis and prevent thromboembolism; however, the mechanisms have not been elucidated. The objective of this study is to assess the effectiveness of antiplatelet medications for Kawasaki disease. We used Medline, Embase, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Ichushi) from January 1947 to August 2018. Studies describing the platelet functions of antiplatelet drugs for Kawasaki disease were included. Twenty studies met the inclusion criteria. There were no randomized controlled trials. Seven studies compared platelet aggregation ability before and after treatment. Eight studies compared platelet aggregation with that in Kawasaki disease patients without treatment. Four studies compared aggregation among different types of antiplatelet drugs or at different doses. Antiplatelet medications administered in the studies included aspirin, flurbiprofen, dipyridamole, and choline salicylate. Methods for the measurement of platelet aggregation ability varied among studies. The groups with antiplatelet treatment tended to have a decreased platelet aggregation function. The statistical analyses were impossible due to insufficient quantitative data and heterogeneity among the studies. Conclusion : The present systematic review revealed that there was insufficient evidence for the effectiveness of antiplatelet therapy for Kawasaki disease. What is Known: • Antiplatelet therapy is widely used for Kawasaki disease to mitigate cardiac complications . • The mechanisms of antiplatelet therapy for Kawasaki disease are not clarified . 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Antiplatelet medications administered in the studies included aspirin, flurbiprofen, dipyridamole, and choline salicylate. Methods for the measurement of platelet aggregation ability varied among studies. The groups with antiplatelet treatment tended to have a decreased platelet aggregation function. The statistical analyses were impossible due to insufficient quantitative data and heterogeneity among the studies. Conclusion : The present systematic review revealed that there was insufficient evidence for the effectiveness of antiplatelet therapy for Kawasaki disease. What is Known: • Antiplatelet therapy is widely used for Kawasaki disease to mitigate cardiac complications . • The mechanisms of antiplatelet therapy for Kawasaki disease are not clarified . 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subjects Aspirin
Child
Choline
Clinical trials
Coronary artery disease
Dipyridamole
Dose-Response Relationship, Drug
Female
Flurbiprofen
Health risk assessment
Heart diseases
Humans
Kawasaki disease
Male
Medicine
Medicine & Public Health
Mucocutaneous lymph node syndrome
Mucocutaneous Lymph Node Syndrome - drug therapy
Original Article
Pediatrics
Platelet aggregation
Platelet Aggregation - drug effects
Platelet Aggregation Inhibitors - pharmacology
Platelet Aggregation Inhibitors - therapeutic use
Salicylic acid
Statistical analysis
Systematic review
Systemic vasculitis
Thromboembolism
Treatment Outcome
title Effectiveness of antiplatelet therapy for Kawasaki disease: a systematic review
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