Objective: To compare the efficacy and safety of infliximab and intravenous immunoglobulin (IVIG) in the treatment of children with refractory Kawasaki disease (rKD). Methods: PubMed

Medline

the Cochrane Library

CNKI

Wanfang and VIP database were retrieved to collect the clinical studies of comparison of infliximab and IVIG in the treatment of rKD. The retrieval time was from the establishment of the database to Mar. 2022. According to the inclusion and exclusion criteria

literature was screened

data were extracted and quality was evaluated. RevMan 5.3 software was used to perform the Meta-analysis. Results: A total of 6 studies were enrolled

including 488 children. Meta-analysis showed that infliximab could improve the effective rate of rKD treatment (OR=2.45

95%CI from 1.47 to 4.09

P=0.000

6) and shorten the duration of fever (SMD=-2.04

95%CI from -3.96 to -0.12

P=0.04). There was no significant difference in the incidence of coronary artery dilatation (OR=1.10

95%CI from 0.62 to 1.95

P=0.74)

incidence of coronary artery aneurysm (OR=1.06

95%CI from 0.52 to 2.17

P=0.88)

Z value-maximum value of coronary artery (SMD=-0.30

95%CI from -0.35 to 0.95

P=0.36) between two groups. There was no significant difference in the incidence of adverse drug reactions between two groups (P>0.05). Conclusion: Compared with repeated administration of IVIG

infliximab can improve the treatment efficiency and shorten the duration of fever in children with rKD. The safety of the two is similar

yet no significant protective effect on cardiovascular disease has been found. Due to the limitation of sample size and literature quality

the results of this study need to be further verified by large-scale high-quality randomized controlled trials.