There is no consensus for the ideal course of steroids One regimen used is IV methylprednisolone at mg/kg/day divided BID for the duration of IV access, with a transition to oral prednisolone mg/kg/day divided BID The decision to treat primary KD with adjunctive agents should be decided in consultation with physicians who have expertise in managing patients with KD The use of corticosteroids in refractory KD is discussed below Adjunctive Therapy With Tumor Necrosis Factor Inhibition Modulation of proinflammatory cytokines, such as TNF-α, has impacted the treatment of rheumatologic conditions including vasculitis Elevated levels of TNF-α are increased in the acute phase of KD Some recent studies suggest that use of biologic response modifiers or biologics for adjunctive therapy of primary KD may show promise A 2019 retrospective study showed a benefit among a high-risk group of patients with KD with CAA (z score ≥2.5, but