Abstract
Although acetylsalicylic acid (ASA) is the most widely used drug in Kawasaki disease because of its anti-inflammatory and antiplatelet effect, a previous study failed to show efficacy of ASA 30 mg/kg/day in reducing coronary involvement in this disease. We have recently documented erratic and often reduced absorption of ASA in Kawasaki disease such that 30 mg/kg/day could not be assumed to yield therapeutic concentrations. In the present study the efficacy of high dose salicylates in reducing the coronary features of Kawasaki disease was assessed in 36 children who received ASA 80-180 mg/kg/day, and 18 who did not receive high dose salicylates during the febrile phase of the disease and whose fever was controlled mainly with acetaminophen. The two groups were comparable with respect to age and body weight. In the ASA-treated group the dose was adjusted to achieve a concentration ≥ 20 mg/dl. There were significantly more cases of coronary disease in the non-treated group (50%) than in the salicylate-treated group (16.6%) (P=0.014). Due to impaired absorption of ASA during the febrile phase of the disease salicylate serum concentrations achieved per given dose were on average 50% those observed during the non-febrile phase. Despite the difficulty in achieving therapeutic concentrations of salicylate during the febrile phase of Kawasaki disease even with doses as high as 100 mg/kg/day, this dose appears to reduce coronary artery involvement.
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Koren, G., Rose, V., Lavi, S. et al. 775 PROBABLE EFFICACY OF HIGH DOSE SALICYLATE IN REDUCING CORONARY INVOLVEMENT IN KAWASAKI DISEASE. Pediatr Res 19, 240 (1985). https://doi.org/10.1203/00006450-198504000-00805
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DOI: https://doi.org/10.1203/00006450-198504000-00805