Imperial College London
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Dr Aubrey Cunnington

Faculty of Medicine, Department of Infectious Disease

Professor of Paediatric Infectious Disease
 
 
 
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Contact

 

+44 (0)20 7594 3695a.cunnington

 
 
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Location

 

244Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{McArdle:2021:10.1056/nejmoa2102968,
author = {McArdle, AJ and Vito, O and Patel, H and Seaby, EG and Shah, P and Wilson, C and Broderick, C and Nijman, R and Tremoulet, AH and Munblit, D and Ulloa-Gutierrez, R and Carter, MJ and De, T and Hoggart, C and Whittaker, E and Herberg, JA and Kaforou, M and Cunnington, AJ and Levin, M},
doi = {10.1056/nejmoa2102968},
journal = {New England Journal of Medicine},
pages = {11--22},
title = {Treatment of multisystem inflammatory syndrome in children},
url = {http://dx.doi.org/10.1056/nejmoa2102968},
volume = {385},
year = {2021}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUNDEvidence is urgently needed to support treatment decisions for children with multisystem inflammatory syndrome (MIS-C) associated with severe acute respiratory syndrome coronavirus 2.METHODSWe performed an international observational cohort study of clinical and outcome data regarding suspected MIS-C that had been uploaded by physicians onto a Web-based database. We used inverse-probability weighting and generalized linear models to evaluate intravenous immune globulin (IVIG) as a reference, as compared with IVIG plus glucocorticoids and glucocorticoids alone. There were two primary outcomes: the first was a composite of inotropic support or mechanical ventilation by day 2 or later or death; the second was a reduction in disease severity on an ordinal scale by day 2. Secondary outcomes included treatment escalation and the time until a reduction in organ failure and inflammation.RESULTSData were available regarding the course of treatment for 614 children from 32 countries from June 2020 through February 2021; 490 met the World Health Organization criteria for MIS-C. Of the 614 children with suspected MIS-C, 246 received primary treatment with IVIG alone, 208 with IVIG plus glucocorticoids, and 99 with glucocorticoids alone; 22 children received other treatment combinations, including biologic agents, and 39 received no immunomodulatory therapy. Receipt of inotropic or ventilatory support or death occurred in 56 patients who received IVIG plus glucocorticoids (adjusted odds ratio for the comparison with IVIG alone, 0.77; 95% confidence interval [CI], 0.33 to 1.82) and in 17 patients who received glucocorticoids alone (adjusted odds ratio, 0.54; 95% CI, 0.22 to 1.33). The adjusted odds ratios for a reduction in disease severity were similar in the two groups, as compared with IVIG alone (0.90 for IVIG plus glucocorticoids and 0.93 for glucocorticoids alone). The time until a reduction in disease severity was similar in the three groups.CONCLUSIONSWe found n
AU  - McArdle,AJ
AU  - Vito,O
AU  - Patel,H
AU  - Seaby,EG
AU  - Shah,P
AU  - Wilson,C
AU  - Broderick,C
AU  - Nijman,R
AU  - Tremoulet,AH
AU  - Munblit,D
AU  - Ulloa-Gutierrez,R
AU  - Carter,MJ
AU  - De,T
AU  - Hoggart,C
AU  - Whittaker,E
AU  - Herberg,JA
AU  - Kaforou,M
AU  - Cunnington,AJ
AU  - Levin,M
DO  - 10.1056/nejmoa2102968
EP  - 22
PY  - 2021///
SN  - 0028-4793
SP  - 11
TI  - Treatment of multisystem inflammatory syndrome in children
T2  - New England Journal of Medicine
UR  - http://dx.doi.org/10.1056/nejmoa2102968
UR  - https://www.nejm.org/doi/10.1056/NEJMoa2102968
UR  - http://hdl.handle.net/10044/1/89787
VL  - 385
ER  -
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