Effectiveness of antiplatelet therapy for Kawasaki disease: a systematic review
Kawasaki disease is an acute systemic vasculitis in children. Antiplatelet medicines are commonly used for Kawasaki disease to attenuate vasculitis and prevent thromboembolism; however, the mechanisms have not been elucidated. The objective of this study is to assess the effectiveness of antiplatelet medications for Kawasaki disease. We used Medline, Embase, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Ichushi) from January 1947 to August 2018. Studies describing the platelet functions of antiplatelet drugs for Kawasaki disease were included. Twenty studies met the inclusion criteria. There were no randomized controlled trials. Seven studies compared platelet aggregation ability before and after treatment. Eight studies compared platelet aggregation with that in Kawasaki disease patients without treatment. Four studies compared aggregation among different types of antiplatelet drugs or at different doses. Antiplatelet medications administered in the studies included aspirin, flurbiprofen, dipyridamole, and choline salicylate. Methods for the measurement of platelet aggregation ability varied among studies. The groups with antiplatelet treatment tended to have a decreased platelet aggregation function. The statistical analyses were impossible due to insufficient quantitative data and heterogeneity among the studies.
What is Known:
• Antiplatelet therapy is widely used for Kawasaki disease to mitigate cardiac complications.
• The mechanisms of antiplatelet therapy for Kawasaki disease are not clarified.
What is New:
• This systematic review showed that the groups with antiplatelet treatment tended to have a decreased platelet aggregation function.
• There is insufficient evidence for the effectiveness of antiplatelet therapy for Kawasaki disease.
KeywordsAntiplatelet Kawasaki disease Pediatrics Systematic review
Consolidated Standards of Reporting Trials
Intravenous immunoglobulin therapy
Preferred Reporting Items for Systematic Reviews and Meta-analyses
Strengthening the Reporting of Observational Studies in Epidemiology
Coronary artery lesion
We thank Ms. Chiemi Kataoka and Ms. Yuko Serizawa, the information specialists at the National Center for Child Health and Development, Tokyo, Japan, and Dr. Reina Isayama, at the Department of Management and Strategy Clinical Research Center, the National Center for Child Health and Development, Tokyo, Japan, for their kind assistance with the literature search. We also appreciate Dr. Chemin Su at the Division of Clinical Research Planning, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan, for his kind support by reading the article written in Chinese.
AI and TK developed the concept of the study. RT, AI, and TK designed the study. RT, RH, and TS selected the eligible studies, collected the data, and summarized the data. RT wrote the initial draft of the manuscript. RH, TS, AI, and TK critically reviewed and revised the manuscript.
This study was funded by the Japan Agency for Medical Research and Development (ek0109142h).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study does not require ethical approval because this is a systematic review of published articles.
Informed consent is not necessary for this study because this is a systematic review of published articles.
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