Intravenous methylprednisolone reduces hospital stay for children with Multisystem Inflammatory Syndrome

Key Findings:

• Intravenous methylprednisolone significantly reduced the duration of hospital stay compared with usual care (mean difference -0.7 days).

• Tocilizumab, as a second-line treatment, demonstrated a substantial reduction in hospital stay duration compared with usual care (mean difference -3.3 days).

• Intravenous immunoglobulin and anakinra showed no significant impact on the duration of hospital stay compared with usual care.

• Few adverse events were reported, with two persistent coronary artery aneurysms in the usual care group.

The RECOVERY trial provides evidence supporting the efficacy of intravenous methylprednisolone as a first-line treatment and tocilizumab as a second-line treatment for pediatric patients with PIMS-TS. However, intravenous immunoglobulin and anakinra did not exhibit notable benefits compared with usual care.

Reference:

Faust, S. N., Haynes, R., Jones, C. E., Staplin, N., Whittaker, E., Jaki, T., Juszczak, E., Spata, E., Wan, M., Bamford, A., Dimitri, P., Finn, A., Furness, J., Ramanan, A. V., Gale, C., Cathie, K., Drysdale, S., Bernatoniene, J., Murray, C., … Zuriaga-Alvaro, A. Immunomodulatory therapy in children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS, MIS-C; RECOVERY): a randomised, controlled, open-label, platform trial. The Lancet. Child & Adolescent Health,2024. https://doi.org/10.1016/s2352-4642(23)00316-4