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Clinical Effectiveness of Biological Immunomodulators in SARS-CoV-2-Associated Multisystem Inflammatory Syndrome in Children: A Systematic Review

Authors
 Ji Young Lee  ;  Jimin Kim  ;  Soo-Han Choi  ;  Dong Hyun Kim  ;  Ki Wook Yun  ;  Yae-Jean Kim  ;  Giang Pham Ha Cao  ;  Miyoung Choi  ;  Jong Gyun Ahn 
Citation
 CHILDREN-BASEL, Vol.11(10) : 1180, 2024-09 
Journal Title
CHILDREN-BASEL
Issue Date
2024-09
Keywords
SARS-CoV-2 ; biological immunomodulators ; pediatric multisystem inflammatory disease
Abstract
Background: Although there is consensus to use immunoglobulins and corticosteroids as first-line treatments for multisystem inflammatory syndrome in children (MIS-C), the effectiveness of biological immunomodulators in patients refractory to standard therapy remains unclear. We aimed to outline real-world data on biological immunomodulators.

Method: A literature search using Ovid-Medline, EMBASE, Cochrane CDSR, and KMBASE was conducted from September 2021 to August 2022; certainty of evidence was assessed via GRADE.

Results: Among 258 studies, 10 were selected for analysis, of which 2 were observational studies (with control groups receiving standard therapy of either intravenous immunoglobulins and/or glucocorticoids) and 8 were single-arm studies. In all, 145 patients were treated with biological immunomodulators (anakinra (72; 49%) or infliximab (65; 44%)). In the first observational study, patients in the anakinra group initially exhibited a lower left ventricular ejection fraction than those in the control group. In the second study, patients in the infliximab group required less additional therapy and showed lower newly developed left ventricular dysfunction rate and reduced C-reactive protein levels. The clinical outcomes associated with each biological agent in single-arm studies were not reported individually.

Conclusions: Biological immunomodulators are feasible therapeutic options for refractory MIS-C. Nevertheless, further research is warranted to demonstrate clinical efficacy.
Files in This Item:
T202406971.pdf Download
DOI
10.3390/children11101180
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Ahn, Jong Gyun(안종균) ORCID logo https://orcid.org/0000-0001-5748-0015
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/201351
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