{"id":30663,"date":"2026-09-26T04:04:00","date_gmt":"2026-09-25T20:04:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30663"},"modified":"2026-09-26T05:59:21","modified_gmt":"2026-09-25T21:59:21","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e5%bc%ba%e7%9a%84%e6%9d%be%e9%be%99%e6%b2%bb%e7%96%97%e5%b7%9d%e5%b4%8e%e7%97%85%e7%9a%84%e9%9a%8f%e6%9c%ba%e4%b8%b4%e5%ba%8a%e8%af%95%e9%aa%8c","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30663","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u5f3a\u7684\u677e\u9f99\u6cbb\u7597\u5ddd\u5d0e\u75c5\u7684\u968f\u673a\u4e34\u5e8a\u8bd5\u9a8c"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Randomized Trial of Adjunctive Prednisolone for Kawasaki Disease<\/h1>\n\n\n\n

Siyuan\u00a0Lin,\u00a0Yuanchen\u00a0He,\u00a0Lan\u00a0He,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med\u00a02026;394:1480-1490<\/h3>\n\n\n\n

DOI: 10.1056\/NEJMoa2511478<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h3>\n\n\n\n

The effect of adjunctive glucocorticoids in the primary treatment of Kawasaki disease in unselected patients remains unknown.<\/p>\n\n\n\n

METHODS<\/h3>\n\n\n\n

In this multicenter, open-label, randomized, controlled trial in China, we assigned participants with newly diagnosed Kawasaki disease in a 1:1 ratio to receive prednisolone plus standard treatment or standard treatment alone. The primary outcome was the occurrence of coronary-artery lesions at 1 month after illness onset. Prespecified key secondary outcomes, for which analyses were not controlled for multiplicity, included receipt of rescue therapy, duration of fever, change in the C-reactive protein (CRP) level, and changes in coronary-artery z scores.<\/p>\n\n\n\n

RESULTS<\/p>\n\n\n\n

A total of 3208 participants underwent randomization, with coronary-artery lesions detected at baseline in 870 of 3184 participants (27.3%). At 1 month, coronary-artery lesions were detected in 16.0% of the participants receiving prednisolone plus standard treatment and in 13.8% of those receiving standard treatment alone (adjusted risk difference, 1.1 percentage points; 95% confidence interval, \u22121.0 to 3.4; P=0.31). Rescue therapy was used in 4.6% of the participants receiving prednisolone plus standard therapy and in 10.1% of those receiving standard treatment alone; the median duration of fever was 8.4 hours and 13.2 hours, respectively, and the reductions in the C-reactive protein level at 72 hours were 67.5 mg per liter and 59.8 mg per liter. Decreases in coronary-artery z scores were similar in the two groups. At 3 months, the incidence of coronary-artery lesions was 12.6% with prednisolone plus standard therapy and 10.5% with standard treatment alone; the percentage of participants with progression of coronary-artery lesions was 28.6% and 28.9%, respectively, and the incidence of medium-to-giant coronary-artery aneurysms was 1.9% and 1.1%. The overall incidence of adverse events did not differ significantly between the two groups.<\/p>\n\n\n\n

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CONCLUSIONS<\/h3>\n\n\n\n

The addition of prednisolone to standard primary treatment for Kawasaki disease did not reduce the incidence of coronary-artery lesions at 1 month after illness onset. (Funded by the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences and the National Natural Science Foundation of China; ClinicalTrials.gov number, NCT04078568<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Randomized Trial of Adjunctive Prednis […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30663"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30663"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30663\/revisions"}],"predecessor-version":[{"id":30670,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30663\/revisions\/30670"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30663"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30663"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30663"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}