New tool twice as accurate at predicting antibody resistance among US children with Kawasaki disease: Scoring system lays groundwork for North America’s first test to predict therapeutic resistance for the rare disease

A new tool under development by University at Buffalo researchers could one day help clinicians better predict resistance to immunoglobulin therapy among children with Kawasaki disease in the United States.

The new tool — described in a study published earlier this year in the Journal of Pediatric Pharmacology and Therapeutics – lays the groundwork for North America’s first test to predict resistance to therapeutic treatments for the rare disease, but severe inflammatory disease.

Compared to the Kobayashi score — the most widely used method in Japan for predicting resistance to the antibody, intravenous immunoglobulin (IVIG), in Kawasaki disease — the UB-developed tool is twice as accurate for Western New York children, achieving a sensitivity (detection) rate of 54%.

“Neither system is highly sensitive, but the new score may more accurately identify IVIG resistance in Western New York children and other North American populations than the Kobayashi score,” says first author and UB alum Jasdip Singh, PharmD, global scientific communications manager at Eli Lilly and Company.

Kawasaki disease is an acute inflammation of the blood vessels that primarily affects children younger than 5 years of age. The illness is the leading cause of acquired heart disease among children in the U.S., according to the Centers for Disease Control and Prevention. If left untreated, children with the disease can experience life-threatening coronary artery aneurysms.

The standard treatment for Kawasaki disease is IVIG and aspirin. Although most cases are resolved after a single dose of IVIG, 10-20% of children are IVIG resistant and have a higher chance of developing coronary artery aneurysms.

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