Hao Yi1, Krista L Lanctôt1, Louis Bont2, Beatrijs L P Bloemers2, Michel Weijerman3, Chantal Broers3, Abby Li1, Alexander Kiss1, Ian Mitchell4, Bosco Paes5. 1. Medical Outcomes and Research in Economics Research Group, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; 2. Division of Infectious Diseases, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, Netherlands; 3. Department of Pediatrics, VU University Medical Center, Amsterdam, Netherlands; 4. Division of Respirology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; and. 5. Division of Neonatology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada paes@mcmaster.ca.
Abstract
BACKGROUND AND OBJECTIVES: Children with Down syndrome (DS) are at significant risk for respiratory syncytial virus (RSV) infection and related hospitalization. We compared hospitalization rates due to respiratory tract infection in children with DS aged <2 years who prospectively received palivizumab during the RSV season with a previously published, similar untreated DS birth cohort. METHODS: A total of 532 children with DS who prospectively received palivizumab were assembled from the prospective Canadian RSV Evaluation Study of Palivizumab registry between 2005 and 2012. The untreated group included 233 children with DS derived from a nationwide Dutch birth cohort from 2003 to 2005. Events during the RSV seasons were counted. Poisson regression analysis was performed to compare incidence rate ratios (95% confidence intervals [CIs]) between groups while controlling for observation length and known risk factors for severe RSV infection. RESULTS: In total, 31 (23 untreated, 8 treated) RSV-related hospitalizations were documented. The adjusted risk of RSV-related hospitalizations was higher in untreated subjects than in palivizumab recipients (incidence rate ratio 3.63; 95% CI, 1.52-8.67). The adjusted risk of hospitalization for all respiratory tract infection (147 events; 73 untreated, 74 treated) was similar (incidence rate ratio untreated versus palivizumab 1.11; 95% CI, 0.80-1.55). CONCLUSIONS: These results suggest that palivizumab is associated with a 3.6-fold reduction in the incidence rate ratio for RSV-related hospitalization in children with DS during the first 2 years of life. A randomized trial is needed to determine the efficacy of RSV immunoprophylaxis in this specific high-risk patient population.
BACKGROUND AND OBJECTIVES:Children with Down syndrome (DS) are at significant risk for respiratory syncytial virus (RSV) infection and related hospitalization. We compared hospitalization rates due to respiratory tract infection in children with DS aged <2 years who prospectively received palivizumab during the RSV season with a previously published, similar untreated DS birth cohort. METHODS: A total of 532 children with DS who prospectively received palivizumab were assembled from the prospective Canadian RSV Evaluation Study of Palivizumab registry between 2005 and 2012. The untreated group included 233 children with DS derived from a nationwide Dutch birth cohort from 2003 to 2005. Events during the RSV seasons were counted. Poisson regression analysis was performed to compare incidence rate ratios (95% confidence intervals [CIs]) between groups while controlling for observation length and known risk factors for severe RSV infection. RESULTS: In total, 31 (23 untreated, 8 treated) RSV-related hospitalizations were documented. The adjusted risk of RSV-related hospitalizations was higher in untreated subjects than in palivizumab recipients (incidence rate ratio 3.63; 95% CI, 1.52-8.67). The adjusted risk of hospitalization for all respiratory tract infection (147 events; 73 untreated, 74 treated) was similar (incidence rate ratio untreated versus palivizumab 1.11; 95% CI, 0.80-1.55). CONCLUSIONS: These results suggest that palivizumab is associated with a 3.6-fold reduction in the incidence rate ratio for RSV-related hospitalization in children with DS during the first 2 years of life. A randomized trial is needed to determine the efficacy of RSV immunoprophylaxis in this specific high-risk patient population.
Authors: Alexander J Millman; Lyn Finelli; Anna M Bramley; Georgina Peacock; Derek J Williams; Sandra R Arnold; Carlos G Grijalva; Evan J Anderson; Jonathan A McCullers; Krow Ampofo; Andrew T Pavia; Kathryn M Edwards; Seema Jain Journal: J Pediatr Date: 2016-03-23 Impact factor: 4.406
Authors: Eric A F Simões; Louis Bont; Paolo Manzoni; Brigitte Fauroux; Bosco Paes; Josep Figueras-Aloy; Paul A Checchia; Xavier Carbonell-Estrany Journal: Infect Dis Ther Date: 2018-02-22