[China Tech] Breakthrough on a Common and Serious Child Disease

China Tech is a column dedicated to the innovations reshaping China – and, inevitably, the world. From cutting-edge AI labs and next-generation robotics to apps that redefine daily life, we explore the breakthroughs that emerge from the country's relentless drive for technological dominance. Some are game-changers, others cautionary tales, but all offer a glimpse into the future as it's being built, at breakneck speed, in China.

A national multicenter clinical study on Kawasaki disease, led by experts in Shanghai, has clarified that hormone therapy administered during the acute phase of the disease fails to reduce the incidence of coronary artery lesions (CALs) – a severe complication caused by the children's disease.

This landmark finding offers critical evidence to guide clinical practice, helping medical practitioners avoid unnecessary hormone administration and mitigate potential associated adverse reactions, said officials from the Children's Hospital of Fudan University, whose researchers led the study.

The report on the groundbreaking discovery was published in The New England Journal of Medicine, one of the world's most prestigious medical publications, on Thursday.

Kawasaki disease is an acute systemic vasculitis that primarily affects children under 5 years of age. It has a global distribution, with the highest and continuously increasing prevalence observed in East Asia.

CALs, triggered by vascular inflammation, represent the most severe complication of the disease, exerting long-term adverse impacts on cardiovascular health, and can lead to critical illness or even death in severe cases.

The current standard treatment for Kawasaki disease involves high-dose intravenous immunoglobulin combined with oral aspirin, administered within 10 days of disease onset. Nevertheless, 10 to 20 percent of patients still develop CALs despite receiving standard treatment, and giant coronary artery aneurysms occur in approximately 0.5 to 1 percent of treated patients.

Therefore, optimizing initial anti-inflammatory therapeutic strategies to further lower the risk of CALs remains a pressing clinical challenge.

As an effective therapeutic agent for most vasculitides, the role of adjuvant corticosteroids in the initial treatment of Kawasaki disease has long garnered widespread global attention, yet relevant research findings have remained controversial.

To resolve this longstanding international debate over acute Kawasaki disease treatment, researchers led by Dr Huang Guoying from the Children's Hospital of Fudan University conducted a large-scale clinical trial involving nearly 3,000 children across 28 hospitals in China.

"This study confirms that adding corticosteroids to standard treatment during the acute phase of Kawasaki disease does not reduce the incidence of coronary artery lesions," Huang said.

"These findings provide key clinical guidance to curb unnecessary corticosteroid use and prevent potential adverse effects. Given that the pathogenesis of Kawasaki disease remains unclear, we will conduct in-depth research on immune and metabolic mechanisms to identify novel therapeutic targets and develop new medications for this disease, which poses a serious threat to children's health."

The incidence of Kawasaki disease is approximately 1 new patient per 1,000 children under 4 years old annually in Shanghai. The rate stands at 3 new patients per 1,000 children in Japan and 2 per 1,000 children in South Korea each year.

"China has established a full-chain system covering Kawasaki disease screening, diagnosis and treatment. For patients with coronary artery lesions, we are capable of performing coronary artery bypass surgery to improve their prognosis and long-term life quality," noted Dr Wang Yi, president of the hospital, which houses the National Kawasaki Disease Quality Control Center.

"Expatriate children diagnosed with the disease are also welcome to seek high-quality treatment and disease management at our hospital, which received some 7,000 foreign patients last year."