Table 1.

Alternate therapies for IVIG resistance in Kawasaki disease

Medicine	Dosage	Mechanistic action	Reference
Methylprednisolone	20−30 mg/kg, maximum 1 g/day (oral administration)	Blocked inflammatory cytokines which resulted in the immunosuppressive effect	[42•]
Prednisone/prednisolone	1−2 mg/kg/day (intravenous injection, oral administration after symptom relief)	Inhibited the transcription of different inflammatory cytokines and promoted the transcription of anti-inflammatory cytokines and proteins	[4,55]
Infliximab	5 mg/kg (intravenous injection)	Binded and inhibited TNF-α, prevented the release of proinflammatory cytokine and interleukin	[4]
Anakinra	2−6 mg/kg/day (oral administration)	Downregulated various IL-1ß-mediated inflammatory responses, and as a receptor antagonist competitively inhibit the binding between IL-1 and the receptor	[4]
Canakinumab	4 mg/kg (body weight <40 kg) (oral administration)	Suppressed the inflammation through the neutralization of IL-1β	[63]
Plasmapheresis (PE)	–	Replaced the plasma harboring the inflammatory cytokines by another colloid including plasma or albumin from donor	[66]
Cyclosporine	4−8 mg/kg/day (intravenous injection or oral administration)	Inhibited the calcineurin-NFAT signaling pathway and increased the activity of T cells	[70]
Methotrexate	10 mg/m2/week (oral administration)	Inhibited lymphocyte proliferation and as a folic acid antagonist	[70]