Biologic Disease-Modifying Antirheumatic Drugs to Treat Multisystem Inflammatory Syndrome in Children

Randy Q. Cron


Curr Opin Rheumatol. 2022;34(5):274-279. 

In This Article


Who would have predicted the MIS-C scourge when COVID-19 began circling the globe?[7] This postinfectious hyper-inflammatory illness of children with features of KD, including coronary artery dilation, presents acutely approximately one month following an asymptomatic or symptomatic SARS-CoV-2 infection in a small subset of children. There are likely genetic risk factors for why some children develop this and most do not, including mutations in genes associated with fHLH and other CSSs. While MIS-C is not identical to MAS and other CSSs, serum from children with MIS-C possess elevated levels of pro-inflammatory cytokines, including IL-1, IL-6, and TNF. Fortuitously, bDMARDs that target these cytokines are useful adjunctive life-saving therapies for children with MIS-C refractory to IVIg and GCs leading to favorable outcomes.