SCCM Resource Library-Methylprednisolone, IV Immunoglobulin, Tocilizumab, or Anakinra for Children With Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS/MIS-C): Report From a Randomized, Controlled, Open-Label Platform Trial (Lancet Child and Adolescent Health)

Methylprednisolone, IV Immunoglobulin, Tocilizumab, or Anakinra for Children With Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS/MIS-C): Report From a Randomized, Controlled, Open-Label Platform Trial (Lancet Child and Adolescent Health)

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Video Transcription

Video Summary

In response to COVID-19 in children, a working group initiated a pragmatic recovery trial aimed at assessing treatments for pediatric multisystem inflammatory syndrome (PIMS-TS) linked to SARS-CoV-2. This trial addressed children, traditionally underrepresented in trials focusing primarily on adults. The study compared the efficacy of intravenous immunoglobulin (IVIG) and corticosteroids with standard care. Notably, methylprednisolone showed an 87% probability of reducing hospital stays and a 97% probability of reducing inflammation. A second-stage trial assessed immunomodulators, tocilizumab and anakinra, versus standard care, where tocilizumab showed a significant reduction in hospital stay but increased reliance on inotropes, suggesting some harm. Anakinra's impact was less clear due to a small sample size. The trial’s adaptive, pragmatic design facilitated enrolment during the pandemic but highlighted challenges in treatment effect detection. Overall, it identified steroids as beneficial in initial PIMS-TS treatment, while tocilizumab showed promise for severe cases.

Asset Caption

One-Hour Concurrent Session | Late-Breaking Studies Affecting Patient Outcomes II

Meta Tag

Content Type Presentation

Membership Level Professional

Membership Level Select

Year 2024

Keywords

PIMS-TS

pediatric trial

intravenous immunoglobulin

methylprednisolone

tocilizumab

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