Hiroyuki Mochizuki1, Satoshi Kusuda2, Kenji Okada3, Shigemi Yoshihara4, Hiroyuki Furuya5, Eric A F Simões6. 1. 1 Department of Pediatrics and. 2. 2 Maternal and Perinatal Center, Tokyo Women's Medical University, Tokyo, Japan. 3. 3 Section of Pediatrics, Department of Medicine, Division of Oral and Medical Management, Fukuoka Dental College, Fukouka, Japan. 4. 4 Department of Pediatrics, Dokkyo Medical University, Mibu, Japan; and. 5. 5 Department of Basic Clinical Science and Public Health, Tokai University School of Medicine, Isehara, Japan. 6. 6 University of Colorado School of Medicine and Center for Global Health, Colorado School of Public Health, Aurora, Colorado.
Abstract
RATIONALE: Respiratory syncytial virus (RSV) induces not only infantile recurrent wheezing but also potentially atopic asthma. OBJECTIVES: To test the effect of RSV infection on development of subsequent atopic asthma, we evaluated whether palivizumab, an anti-RSV monoclonal antibody, by preventing severe RSV disease in the first year of life, could impact subsequent recurrent wheezing and atopic asthma at 6 years of age. METHODS: During the 2007 to 2008 RSV season, the decision to administer palivizumab was made based on standard medical practice and an observational prospective multicenter (n = 52) case-control study in preterm infants with a gestational age between 33 and 35 weeks followed from 0 to 3 years (preceding Committee on Recurrent Wheezing study). The 52 investigators at hospitals then followed these subjects until 6 years of age, reported here (Effects of Preventive Treatment for Respiratory Syncytial [RS] Virus Infection During Infancy on Later Atopic Asthma in Preterm Infants; Scientific Committee for Elucidation of Infantile Asthma). Parents of study subjects reported the infants' physicians' assessment of recurrent wheezing, using a report card and a novel mobile phone-based reporting system using the Internet. The primary endpoint was the incidence of atopic asthma. MEASUREMENTS AND MAIN RESULTS: Of 444 preterm infants enrolled, 349 received palivizumab during the first year of life. At 6 years, atopic asthma was not different in the groups: 15.3 and 18.2% of infants in the treated and untreated groups, respectively (P = 0.57). On the other hand, physician-diagnosed recurrent wheezing was observed in 15.3 and 31.6% in the treated and untreated groups, respectively (P = 0.003). CONCLUSIONS: Palivizumab prophylaxis administered to preterm infants did not suppress the onset of atopic asthma but resulted in a significantly lower incidence of recurrent wheezing during the first 6 years. Clinical trial registered with www.clinicaltrials.gov (NCT 01545245).
RATIONALE: Respiratory syncytial virus (RSV) induces not only infantile recurrent wheezing but also potentially atopic asthma. OBJECTIVES: To test the effect of RSV infection on development of subsequent atopic asthma, we evaluated whether palivizumab, an anti-RSV monoclonal antibody, by preventing severe RSV disease in the first year of life, could impact subsequent recurrent wheezing and atopic asthma at 6 years of age. METHODS: During the 2007 to 2008 RSV season, the decision to administer palivizumab was made based on standard medical practice and an observational prospective multicenter (n = 52) case-control study in preterm infants with a gestational age between 33 and 35 weeks followed from 0 to 3 years (preceding Committee on Recurrent Wheezing study). The 52 investigators at hospitals then followed these subjects until 6 years of age, reported here (Effects of Preventive Treatment for Respiratory Syncytial [RS] Virus Infection During Infancy on Later Atopic Asthma in Preterm Infants; Scientific Committee for Elucidation of Infantile Asthma). Parents of study subjects reported the infants' physicians' assessment of recurrent wheezing, using a report card and a novel mobile phone-based reporting system using the Internet. The primary endpoint was the incidence of atopic asthma. MEASUREMENTS AND MAIN RESULTS: Of 444 preterm infants enrolled, 349 received palivizumab during the first year of life. At 6 years, atopic asthma was not different in the groups: 15.3 and 18.2% of infants in the treated and untreated groups, respectively (P = 0.57). On the other hand, physician-diagnosed recurrent wheezing was observed in 15.3 and 31.6% in the treated and untreated groups, respectively (P = 0.003). CONCLUSIONS:Palivizumab prophylaxis administered to preterm infants did not suppress the onset of atopic asthma but resulted in a significantly lower incidence of recurrent wheezing during the first 6 years. Clinical trial registered with www.clinicaltrials.gov (NCT 01545245).
Authors: Tebeb Gebretsadik; Pingsheng Wu; Kecia Carroll; William Dupont; Tina Hartert Journal: Am J Respir Crit Care Med Date: 2017-07-01 Impact factor: 21.405
Authors: Kohei Hasegawa; Tadahiro Goto; Atsushi Hirayama; Federico R Laham; Jonathan M Mansbach; Pedro A Piedra; Carlos A Camargo Journal: Pediatr Infect Dis J Date: 2019-08 Impact factor: 2.129