Cardiac assessment and inflammatory markers in children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV2 (PIMS-TS) treated with methylprednisolone versus intravenous immunoglobulins: 6-month follow-up outcomes of the randomised controlled Swissped RECOVERY trial.
Details
Serval ID
serval:BIB_C445970A123F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cardiac assessment and inflammatory markers in children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV2 (PIMS-TS) treated with methylprednisolone versus intravenous immunoglobulins: 6-month follow-up outcomes of the randomised controlled Swissped RECOVERY trial.
Journal
EClinicalMedicine
Working group(s)
Swissped RECOVERY Trial Group
Contributor(s)
Andre M.C., Sanchez C., Bressieux-Degueldre S., Perez M.H., Wütz D., Blanchard-Rohner G., Grazioli S., Schöbi N., Trück J., Welzel T., Atkinson A., Schlapbach L.J., Bielicki J., Koehler H., Gysi S., Janz I., Bieri A., Donner B., Hammer J., Heininger U., von Kalckreuth C., Kohns M., Mettauer N., Meyer A., Reppucci D., Schlaeppi C., Trachsel D., Vaezipour N., Woerner A., Zutter A., Vanoni F., Kottanattu L., Mazzara C., Conti A.S., Aebi C., Agyeman P., Duppenthaler A., Glöckler M., Pallivathukal S., Riedel T., Zimmermann P., Cudré-Cung H.P., Pavlovic M., Bordessoule A., Martin A.L., Polito A., Wagner N., Rohr M., L'Huillier A., Amiet V., Ferry T., Longchamp D., Natterer J., Oppenheim R., Hofer M., Buettcher M., Wechselberger K., Donas A., Germann S., Erni M.L., Kaiser D., Scholl K.S., Kuen H.P., Hrup K., Stritt J., Bailey D.G., Wachinger T., Beck I., Birkenmaier A., Rogdo B., Lorenz P., Iglowstein I., Zöhrer K., Flade M., Prader S., Schmid J.P., Seiler M., Sauteur P.M., Brotschi B., Weber K., Whittaker E., Faust S.N.
ISSN
2589-5370 (Electronic)
ISSN-L
2589-5370
Publication state
Published
Issued date
01/2024
Peer-reviewed
Oui
Volume
67
Pages
102358
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Publication Status: epublish
Abstract
Previous findings from the Swissped RECOVERY trial showed that patients with Pediatric Inflammatory Multisystem Syndrome-Temporally Associated with SARS-CoV-2 (PIMS-TS) who were randomly assigned to intravenous immunoglobulins or methylprednisolone have a comparable length of hospital stay. Here, we report the 6-month follow-up outcomes of cardiac pathologies and normalisation of clinical or laboratory signs of inflammation from this study population.
This pre-planned follow-up of patients with PIMS-TS included the Swissped RECOVERY Trial reports on the 6-month outcomes of the cohort after randomisation, with a focus on cardiac, haematological, and biochemical findings. The trial was an investigator-initiated randomised multicentre open-label two-arm trial in children and adolescents hospitalised with PIMS-TS at ten hospitals in Switzerland. Cardiological assessments and laboratory analyses were prospectively collected in the intention-to-treat analysis on pre-defined intervals after hospital discharge. Differences between randomised arms were investigated using Chi-square test for categorical and Wilcoxon test for continuous variables. The trial is registered with the Swiss National Clinical Trials Portal (SNCTP000004720) and ClinicalTrials.gov (NCT04826588).
Between May 21, 2021 and April 15, 2022, 75 patients with a median age of 9.1 years (IQR 6.2-12.2) were included in the intention-to-treat population (37 in the methylprednisolone group and 38 in the intravenous immunoglobulin group). During follow-up, the incidence of abnormal left ventricular systolic function, coronary artery aneurysms (CAA), and other signs of inflammation were comparable in both groups. However, we detected cardiac abnormalities with low incidence and a mild degree grade of pathology. CAAs were observed in 2/38 children (5.3%) in the IVIG group and 1/37 children (2.7%) in the methylprednisolone group at 6-month follow-up (difference proportion 0.75; 95% confidence interval (CI) -0.05 to 1.0; p = 0.39).
Methylprednisolone alone may be an acceptable first-line treatment as left ventricular systolic dysfunction and clinical/laboratory evidence for inflammation quickly resolved in all children. However, our findings need further confirmation through larger studies as our sample size is likely to be of insufficient power to address rare clinically relevant adverse outcomes.
NOMIS, Vontobel, and Gaydoul Foundation.
This pre-planned follow-up of patients with PIMS-TS included the Swissped RECOVERY Trial reports on the 6-month outcomes of the cohort after randomisation, with a focus on cardiac, haematological, and biochemical findings. The trial was an investigator-initiated randomised multicentre open-label two-arm trial in children and adolescents hospitalised with PIMS-TS at ten hospitals in Switzerland. Cardiological assessments and laboratory analyses were prospectively collected in the intention-to-treat analysis on pre-defined intervals after hospital discharge. Differences between randomised arms were investigated using Chi-square test for categorical and Wilcoxon test for continuous variables. The trial is registered with the Swiss National Clinical Trials Portal (SNCTP000004720) and ClinicalTrials.gov (NCT04826588).
Between May 21, 2021 and April 15, 2022, 75 patients with a median age of 9.1 years (IQR 6.2-12.2) were included in the intention-to-treat population (37 in the methylprednisolone group and 38 in the intravenous immunoglobulin group). During follow-up, the incidence of abnormal left ventricular systolic function, coronary artery aneurysms (CAA), and other signs of inflammation were comparable in both groups. However, we detected cardiac abnormalities with low incidence and a mild degree grade of pathology. CAAs were observed in 2/38 children (5.3%) in the IVIG group and 1/37 children (2.7%) in the methylprednisolone group at 6-month follow-up (difference proportion 0.75; 95% confidence interval (CI) -0.05 to 1.0; p = 0.39).
Methylprednisolone alone may be an acceptable first-line treatment as left ventricular systolic dysfunction and clinical/laboratory evidence for inflammation quickly resolved in all children. However, our findings need further confirmation through larger studies as our sample size is likely to be of insufficient power to address rare clinically relevant adverse outcomes.
NOMIS, Vontobel, and Gaydoul Foundation.
Keywords
Children, Coronary artery aneurysm, Immunoglobulins, Methylprednisolone, Pims-ts, Rct, PIMS-TS, RCT
Pubmed
Web of science
Open Access
Yes
Create date
21/12/2023 15:23
Last modification date
27/01/2024 7:36
Usage data
