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The protective effect of biologic and targeted-synthetic therapies on developing multisystem inflammatory syndrome in

Lana Khoury1, Adi Miller-Barmak1,2, Shereen Shehadeh1,3,4

  • 1Department of Pediatrics, Carmel Medical Center, Haifa, Israel.

Frontiers in Pediatrics
|August 4, 2025
PubMed

Insights

Biologic and targeted-synthetic therapies may prevent Multisystem Inflammatory Syndrome in Children (MIS-C) after COVID-19 infection. None of the treated children developed MIS-C, suggesting a potential protective effect warranting further research.

Area of Science:

  • Pediatric Immunology
  • Infectious Diseases
  • Pharmacology

Background:

  • Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe complication following COVID-19 infection.
  • Limited data exists on the preventative role of biologic and targeted-synthetic therapies for MIS-C.
  • Investigating these therapies could inform clinical practice for post-COVID-19 pediatric care.

Purpose of the Study:

  • To investigate the potential of biologic and targeted-synthetic therapies in preventing MIS-C development in children.
  • To assess the association between these advanced therapies and the occurrence of MIS-C post-COVID-19.

Main Methods:

  • Analysis of a large cohort of 793,909 children aged 0-18 years with confirmed COVID-19 from the Clalit Health Services database.
  • Adjudication of MIS-C diagnoses using CDC and WHO case definitions.
  • Comparison of outcomes between children receiving biologic/targeted-synthetic therapies and a control group.

Main Results:

  • Among 793,909 COVID-19 cases, 573 children received biologic and targeted-synthetic therapies.
  • No cases of MIS-C were identified in the subgroup of children treated with these advanced therapies.
  • A total of 143 MIS-C cases were identified in the overall cohort.

Conclusions:

  • The study suggests a potential protective association between biologic and targeted-synthetic therapies and a reduced risk of MIS-C.
  • Absence of MIS-C cases in the treated group, while not statistically significant due to small numbers, supports the hypothesis of treatment efficacy.
  • Further prospective studies with larger cohorts are necessary to confirm these findings and understand the underlying mechanisms.
Abstract

Keywords:
COVID-19MIS-Cbiological treatmentspediatrictargeted-synthetic therapies

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