IVIG Plus Methylprednisolone better than IVIG Alone in MIS-C: JAMA study

The primary outcome was defined as the persistence of fever 2 days after the introduction of initial therapy or recrudescence of fever within 7 days, which defined treatment failure whereas, the secondary outcomes included a second-line therapy, hemodynamic support, acute left ventricular dysfunction after first-line therapy, and length of stay in the pediatric intensive care unit.

The following key findings were highlighted-

1. Treatment with IVIG and methylprednisolone vs IVIG alone was associated with a lower risk of treatment failure (absolute risk difference, −0.28 [95% CI, −0.48 to −0.08]; odds ratio [OR], 0.25 [95% CI, 0.09 to 0.70]; P = .008).
2. IVIG and methylprednisolone therapy vs IVIG alone was also significantly associated with a lower risk of use of second-line therapy (absolute risk difference, −0.22 [95% CI, −0.40 to −0.04]; OR, 0.19 [95% CI, 0.06 to 0.61];
   P = .004), hemodynamic support (absolute risk difference, −0.17 [95% CI, −0.34 to −0.004]; OR, 0.21 [95% CI, 0.06 to 0.76]), acute left ventricular dysfunction occurring after initial therapy (absolute risk difference, −0.18 [95% CI, −0.35 to −0.01]; OR, 0.20 [95% CI, 0.06 to 0.66]), and duration of stay in the pediatric intensive care unit (median, 4 vs 6 days; the difference in days, −2.4 [95% CI, −4.0 to −0.7]).

Therefore, it was concluded that "among children with MIS-C, treatment with IVIG and methylprednisolone vs IVIG alone were associated with a more favorable fever course."