Is aspirin necessary in the acute phase of Kawasaki disease?

To explore whether aspirin is necessary for treatment in the acute phase of Kawasaki disease (KD).

Nine hundred ten patients who fulfilled the criteria of KD and maintained follow-up for 2 years were included in this retrospective study. All patients initially received a single dose of intravenous immunoglobulin (IVIG, 2 g/kg) in the acute phase. Patients were classified into three groups according to the doses of aspirin. Group 1 included 152 cases treated with IVIG only in the acute phase. Group 2 included 672 cases treated with IVIG plus 3-5 mg/kg/day aspirin as the low-dose group, and group 3 included 86 cases treated with IVIG plus 30-50 mg/kg/day aspirin as the moderate-dose group. Changes in inflammatory indices and platelet count after treatment were compared by one-way analysis of variance or analysis of covariance to analyse the clinical effect of aspirin in acute KD. The relationship between aspirin use and coronary artery lesion complications was analysed by logistic regression.

There was no significant difference among the three groups in terms of the anti-inflammation effect revealed by C-reactive protein level, white blood cell count, percentage of neutrophils in white blood cells, decreasing platelet count or prevention of the formation of coronary artery lesion.

The role of aspirin in the treatment of the acute phase of KD should be questioned as a definite benefit has not been shown in our study. Further prospective studies incorporating large multicentre samples of patients are needed to confirm this finding.