{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Melgar M"],"funding":["MRF","Medical Research Foundation","Centers for Disease Control and Prevention","Horizon 2020 Framework Programme","National Institute for Health Research (NIHR)","NIHR Imperial Biomedical Research Centre","Lee Family Foundation","National Institutes of Health","Wellcome Trust","NIH HHS","CDC HHS"],"pagination":["804-810"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9469482"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["4(9)"],"pubmed_abstract":["<h4>Objective</h4>Two cohort studies in patients with multisystem inflammatory syndrome in children (MIS-C) demonstrated contrasting results regarding the benefit of initial immunomodulatory treatment with intravenous immunoglobulin (IVIG) alone versus IVIG and glucocorticoids. We sought to determine whether application of different MIS-C definitions and differing disease severity between cohorts underlay discrepant results.<h4>Methods</h4>The Overcoming COVID-19 Public Health Surveillance Registry (OC-19) included patients meeting the US Centers for Disease Control and Prevention (CDC) MIS-C definition, whereas the Best Available Treatment Study (BATS) applied the World Health Organization (WHO) definition. We applied the WHO definition to the OC-19 cohort and the CDC definition to the BATS cohort and determined the proportion that did not meet the alternate definition. We compared illness severity indicators between cohorts.<h4>Results</h4>Of 349 OC-19 patients, 9.5% did not meet the WHO definition. Of 350 BATS patients, 10.3% did not meet the CDC definition. Most organ system involvement was similar between the cohorts, but more OC-19 patients had WHO-defined cardiac involvement (87.1% vs 79.4%, P = 0.008). OC-19 patients were more often admitted to intensive care (61.0% vs 44.8%, P < 0.001) and more often received vasopressors or inotropes (39.5% vs 22.9%, P < 0.001) before immunomodulatory treatment.<h4>Conclusion</h4>Greater illness severity and cardiovascular involvement in the OC-19 cohort compared with the BATS cohort, and not use of different MIS-C case definitions, may have contributed to differing study conclusions about optimal initial treatment for MIS-C. Disease severity should be considered in future MIS-C study designs and treatment recommendations to identify patients who would benefit from aggressive immunomodulatory treatment."],"journal":["ACR open rheumatology"],"pubmed_title":["Treatment of Multisystem Inflammatory Syndrome in Children: Understanding Differences in Results of Comparative Effectiveness Studies."],"pmcid":["PMC9469482"],"funding_grant_id":["75D30120C07725","RDA02","668303 PERFORM","GA5R01AI128765","206508/Z/17/Z","MRF‐160‐0008‐ELP‐KAFO‐C0801","ACL‐2018‐021‐007","848196 DIAMONDS","203928/Z/16/Z","ACL-2018-021-007","MRF-160-0008-ELP-KAFO-C0801"],"pubmed_authors":["Murray NL","Melgar M","Seaby EG","McArdle AJ","Randolph AG","Young CC","Patel MM","BATS Consortium and the Overcoming COVID-19 Investigators","Levin M","Campbell AP","Son MBF"],"additional_accession":[]},"is_claimable":false,"name":"Treatment of Multisystem Inflammatory Syndrome in Children: Understanding Differences in Results of Comparative Effectiveness Studies.","description":"<h4>Objective</h4>Two cohort studies in patients with multisystem inflammatory syndrome in children (MIS-C) demonstrated contrasting results regarding the benefit of initial immunomodulatory treatment with intravenous immunoglobulin (IVIG) alone versus IVIG and glucocorticoids. We sought to determine whether application of different MIS-C definitions and differing disease severity between cohorts underlay discrepant results.<h4>Methods</h4>The Overcoming COVID-19 Public Health Surveillance Registry (OC-19) included patients meeting the US Centers for Disease Control and Prevention (CDC) MIS-C definition, whereas the Best Available Treatment Study (BATS) applied the World Health Organization (WHO) definition. We applied the WHO definition to the OC-19 cohort and the CDC definition to the BATS cohort and determined the proportion that did not meet the alternate definition. We compared illness severity indicators between cohorts.<h4>Results</h4>Of 349 OC-19 patients, 9.5% did not meet the WHO definition. Of 350 BATS patients, 10.3% did not meet the CDC definition. Most organ system involvement was similar between the cohorts, but more OC-19 patients had WHO-defined cardiac involvement (87.1% vs 79.4%, P = 0.008). OC-19 patients were more often admitted to intensive care (61.0% vs 44.8%, P < 0.001) and more often received vasopressors or inotropes (39.5% vs 22.9%, P < 0.001) before immunomodulatory treatment.<h4>Conclusion</h4>Greater illness severity and cardiovascular involvement in the OC-19 cohort compared with the BATS cohort, and not use of different MIS-C case definitions, may have contributed to differing study conclusions about optimal initial treatment for MIS-C. Disease severity should be considered in future MIS-C study designs and treatment recommendations to identify patients who would benefit from aggressive immunomodulatory treatment.","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Sep","modification":"2025-04-05T10:45:27.394Z","creation":"2025-04-05T10:45:27.394Z"},"accession":"S-EPMC9469482","cross_references":{"pubmed":["35759535"],"doi":["10.1002/acr2.11478"]}}