We appreciate your commentsReference Zhang and Chen 1 on “A meta-analysis of re-treatment for intravenous immunoglobulin-resistant Kawasaki disease”.Reference Yang, Liu and Huang 2
It is known that Kawasaki disease is a common problem in paediatric cardiology, and it is now the most common acquired paediatric cardiovascular disease in developed countries. Intravenous immunoglobulin plus high-dose aspirin therapy remains the initial treatment of choice for Kawasaki disease. For those who are resistant to intravenous immunoglobulin, two most common therapies are additional intravenous immunoglobulin or intravenous corticosteroids. That’s why our meta-analysis mainly focussed on the comparison between intravenous immunoglobulin and corticosteroids. There are other treatments including infliximab, cyclosporine, methotrexate, and plasma exchange, etc;Reference Saneeymehri, Baker and So 3 , Reference Patel and Shulman 4 however, up to now, randomised controlled clinical trials have been limited in meta-analysis about those therapeutic options for patients resistant to initial therapy. Considering the paucity of data, we did not cover infliximab in this meta-analysis report.
Among the four selected studies, two belonged to the same author team.Reference Miura, Ohki and Yoshiba 5 , Reference Miura, Kohno, Ohki, Yoshiba, Sugaya and Satoh 6 When conducting the meta-analysis, we didn’t consider them as the same trial, as the number of cases was different in each trial, and detailed patient information such as age, gender, etc. was not clearly provided in the original paper; however, if the data do come from the same trial of different stages, it would weaken the validity of further analyses.
Yongbing Chen, Junbao Du
Department of Pediatrics Peking University First Hospital Beijing, China
