Study confirms effectiveness of palivizumab against RSV in high-risk infants

Publication
Article
Contemporary PEDS JournalVol 37 No 1
Volume 37
Issue 1

Palivizumab appears to be effective for reducing respiratory syncytial virus (RSV) in high-risk infants, according to results of a study in Australia.

Palivizumab appears to be effective for reducing respiratory syncytial virus (RSV) in high-risk infants, according to results of a study in Australia. Researchers conducted a retrospective  birth cohort study of more than 23,000 high-risk infants admitted to neonatal intensive care units who were born from 2002 to 2013 with follow-up to 2015. To address confounding by indication in the cohort study (ie, that palivizumab was targeted to those at greatest risk of RSV), researchers supplemented this analysis with a self-controlled case series (SCCS) study.

In the cohort group, 1.1% of the infants received at least 1 dose of palivizumab, with use increasing over time. The number of doses ranged from 1 to 15, and more than 90% of them were administered to infants aged younger than 12 months. Overall, there were 1689 positive RSV tests before the age of 2 years, representing 1506 infants (6.2%) with at least 1 RSV detection before age 2 years. More than 10% of these infants also had another episode of RSV detection before their second birthday. Overall, receiving palivizumab was not associated with lower risk of RSV detection before age 2 years.

However, results of the SCCS study, which accounted for confounding by indication and focused on 1506 infants with 1 or more RSV detections who had at least 1 dose of palivizumab, were different. The incidence of RSV detection before age 2 years was 70% lower in the 28 days after the first dose of palivizumab than it was in control periods, and the rate of RSV detections was reduced by 74% in the 28 days after any dose (Moore HC, et al. J Pediatr. 2019; 214:121.e1-127.e1).

Thoughts from Dr Farber

I have never been completely convinced that palivizumab is worth the cost, yet I prescribe it. This study, although hardly conclusive, makes me feel better about giving it.

Recent Videos
cUTI Roundtable: Discussing and diagnosing these difficult infections
Courtney Nelson, MD
Tina Tan, MD, FAAP, FIDSA, FPIDS, editor in chief, Contemporary Pediatrics, professor of pediatrics, Feinberg School of Medicine, Northwestern University, pediatric infectious diseases attending, Ann & Robert H. Lurie Children's Hospital of Chicago
Related Content
© 2024 MJH Life Sciences

All rights reserved.