RT Journal Article
SR Electronic
T1 Respiratory syncytial virus prophylaxis in Down syndrome: A prospective cohort study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P1260
VO 44
IS Suppl 58
A1 Mitchell, Ian
A1 Yi, Hao
A1 Kiss, Alexander
A1 Li, Abby
A1 Lanctot, Krista
A1 Bont, Louis
A1 Bloemers, Beatrijs
A1 Weijerman, Michel
A1 Broers, Chantal
A1 Paes, Bosco
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P1260.abstract
AB Background/Objective: Down syndrome (DS) children are at significant risk for respiratory tract (RTI) and respiratory syncytial virus (RSV) infection and hospitalization. We compared hospitalization rates for RTI in DS children aged < 2 years given palivizumab in the RSV season versus a previously published, similar untreated DS birth cohort.Methods: 532 prophylaxed DS children were from the Canadian palivizumab registry (CARESS) between 2005-2012. The untreated group comprised 233 DS children derived from a Dutch, nation-wide birth cohort from 2003-2005. Events during the RSV seasons were counted. Demographics and risk factors were compared using t-test or chi-square where appropriate. Poisson regression analysis was performed to compare incidence rate ratios [95% CI] for both RTI and confirmed RSV hospitalization between the 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 compared to palivizumab recipients (incidence rate ratio 3.63 [95% CI: 1.52-8.67], p=0.004). The adjusted risk for hospitalization for all respiratory tract infection (147 events; 73 untreated, 74 treated) was similar (incidence rate ratio untreated versus palivizumab 1.11 [0.80 – 1.55], p=0.53).Conclusions: These results suggest that palivizumab is associated with a 3.6-fold reduction in the incidence rate ratio for RSV-related hospitalization in DS children aged <2 years. A randomized trial is needed to determine the efficacy of RSV immunoprophylaxis in this specific high risk patient population.