Dual therapy improves cardiac outcomes in pediatric patients suffering from MIS-C

A recent study by a multidisciplinary team of cardiologists and infectious disease specialists at Children’s Hospital Colorado (Children’s Colorado) found that pediatric patients suffering from Multisystem Inflammatory Syndrome (MIS-C) receiving initial intensive therapy consisting of from intravenous immunoglobulin (IVIG) plus infliximab had improved cardiac outcomes compared to those receiving IVIG alone. In addition, those patients had a reduced need for additional therapies, a shorter ICU stay, a reduced development of left ventricular dysfunction and a faster healing of inflammation. Infliximab is a drug commonly used to treat autoimmune diseases.

As a result of the improved outcomes associated with IVIG plus Infliximab, Children’s Colorado has updated its MIS-C care pathway to recommend administration of intensified initial therapy (IVIG plus Infliximab) for all patients strongly suspected or diagnosed with MIS- c. MIS-C is a condition in which various parts of the body can become inflamed, including the heart, lungs, kidneys and brain, and has been linked to the virus that causes COVID-19.

While further randomized controlled trials are needed to confirm these findings, the demonstrated improvement in cardiac and other outcomes associated with IVIG plus Infliximab made it imperative that we share this updated clinical pathway as soon as possible.”

Sam Dominguez, MD, PhD, infectious disease specialist at Children’s Colorado and co-author of the study

The study, released for publication in Pediatrics on Sept. 20 to accelerate access to the findings, is based on a retrospective cohort study of 72 pediatric MIS-C patients comparing the results of those who received initial treatment with IVIG alone. with those who received initial treatment with IVIG plus Infliximab.

“Children’s Colorado has extensive experience treating high-risk patients with Kawasaki disease (KD) with IVIG plus Infliximab, reducing the need for additional therapies and the duration of treatment,” said Pei Ni Jone, MD, cardiologist, director of Kawasaki disease. Clinic at Children’s Colorado and co-author of the study. “All MIS-C patients at Children’s Colorado, who are typically more ill than KD patients, are now treated with an initial dual therapy to improve overall outcomes.”


Colorado Children’s Hospital

Reference magazine:

Cole, LD, et al. (2021) IVIG Compared to IVIG Plus Infliximab in Multisystem Inflammatory Syndrome in Children. Pediatrics. doi.org/10.1542/peds.2021-052702.

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