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Effectiveness of Palivizumab against Respiratory Syncytial Virus: Cohort and Case Series Analysis.
- Source :
-
The Journal of pediatrics [J Pediatr] 2019 Nov; Vol. 214, pp. 121-127.e1. Date of Electronic Publication: 2019 Aug 01. - Publication Year :
- 2019
-
Abstract
- Objective: To measure the real-world effectiveness of palivizumab immunoprophylaxis against respiratory syncytial virus (RSV)-confirmed infection before age 2 years in a population-cohort of high-risk infants.<br />Study Design: Palivizumab is funded for high-risk infants in Western Australia. We used probabilistically linked administrative data encompassing RSV laboratory-confirmed infections, hospital admissions, and palivizumab dispensing records for a cohort of 24 329 high-risk infants admitted to neonatal intensive care units, born 2002-2013 with follow-up to 2015. We used a traditional cohort method with Cox proportional hazards regression and a self-controlled case series analysis to assess effectiveness of palivizumab in reducing RSV-confirmed infection by number of doses.<br />Results: From the cohort of 24 329 infants, 271 (1.1%) received at least 1 dose of palivizumab and 1506 (6.2%) had at least 1 RSV-confirmed infection before age 2 years. Using the traditional cohort approach, we found no protective association of palivizumab receipt with RSV detection (adjusted hazard ratio = 0.99 [95% CI 0.5, 1.9] for 1 dose). However, using a self-controlled case series to eliminate confounding by indication, a protective association was seen with a 74% lower RSV incidence (relative incidence = 0.26; 95% CI 0.11, 0.67) following any dose of palivizumab compared with control (nonexposed) periods.<br />Conclusions: After accounting for confounding by indication through a self-controlled analysis, palivizumab appeared effective for reducing virologically confirmed RSV in this high-risk cohort.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Antiviral Agents administration & dosage
Child, Preschool
DNA, Viral analysis
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Humans
Incidence
Infant
Infant, Newborn
Intensive Care Units, Neonatal statistics & numerical data
Male
Respiratory Syncytial Virus Infections epidemiology
Respiratory Syncytial Virus Infections virology
Retrospective Studies
Risk Factors
Western Australia epidemiology
Palivizumab administration & dosage
Respiratory Syncytial Virus Infections drug therapy
Respiratory Syncytial Virus, Human genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6833
- Volume :
- 214
- Database :
- MEDLINE
- Journal :
- The Journal of pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 31378522
- Full Text :
- https://doi.org/10.1016/j.jpeds.2019.06.058