Expert consensus on aspirin use in children with Kawasaki disease

Title: Expert consensus on aspirin use in children with Kawasaki disease
Edition: Original
Classification: Experts consensus
Field: Treatment
Countries and regions: China
Guidelines users: Use of this consensus includes all pediatric rheumatology and pediatric cardiovascular physicians and general practitioners.
Evidence classification method: The evidence recommendation grading evaluation, formulation and evaluation method (GRADE) was used to determine the recommendation level of a clinical issue in this consensus according to the credibility level of literature or data under the guidance of the GRADE manual.
Development unit: 陕西省川崎病诊疗中心;陕西省人民医院儿童病院
Registration time: 2021-10-09
Registration number: IPGRP-2021CN321
Purpose of the guideline: At present, many studies have shown that aspirin has good efficacy, safety and compliance in the treatment of Kawasaki disease at home and abroad. However, there are also some problems, challenges and controversies in the treatment of kawasaki disease, such as the optimal dose, duration of use and adverse reactions. In particular, there is the issue of aspirin dose: although it has been shown to significantly reduce the risk of coronary artery abnormalities, the optimal dose of aspirin is not known, leading to significant differences in practice between 80-100mg/kg/ day in European and American populations and 30-50mg/kg/ day in Asian populations. High-dose aspirin is used as an anti-inflammatory, while low-dose aspirin has antithrombotic effects. These two effects are considered to be useful in the initial stage of KD, but several reports suggest that ASA does not seem to reduce the frequency of coronary artery abnormalities, and considering the adverse reactions of aspirin, especially high-dose aspirin can lead to gastrointestinal ulcer, bleeding, nasal bleeding, liver and kidney function damage and other adverse reactions, Questions about aspirin's utility and optimal dose are open to debate.