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Palivizumab prophylaxis for respiratory syncytial virus in infants with cystic fibrosis: is there a need?

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Respiratory syncytial virus (RSV) infection in cystic fibrosis (CF) infants is associated with significant morbidities. This study’s objective is to evaluate the effectiveness and adverse events related to palivizumab (PVZ) in CF infants. Data on respiratory-related illness (RIH) and RSV hospitalizations (RSVH) were collected retrospectively in CF infants aged < 2 years in Alberta, Canada, from 2000 to 2017. Logistic regression models were used to compare the odds of RSVH or RIH in PVZ infants from the Canadian registry of palivizumab (CARESS) versus untreated (UPVZ) infants from Alberta, after adjusting for potential confounders. Illness severity was compared between cohorts using χ2 and t tests. A total of 267 CF infants were included: 183 (PVZ) and 84 (UPVZ). A total of 53.3% were tested for RSV. Fifty-five infants experienced a RIH and 10 had a RSVH. The PVZ cohort experienced similar odds of RSVH but decreased odds of RIH versus UPVZ, adjusting for gestational age, birth weight, birth during RSV peak months, and presence of siblings (Exp(B) = 0.23 [0.11–0.49], p < 0.0005). In RSVH-related subjects, PVZ subjects experienced shorter length of overall stay (LOS; t = 2.39 [df = 7], p = 0.048). In those with a RIH, the PVZ group had shorter overall intensive care unit (t = 3.52 [df = 15], p = 0.003) and hospital LOS (t = 2.11 [df = 52], p = 0.04). No serious adverse events were related to PVZ. The odds of RSVH were similar between groups, but PVZ subjects had decreased odds of RIH. The low number of RSV tests performed may explain the similarity in RSVH rates. Significant differences in LOS may indicate decreased RSVH and RIH illness severity in the PVZ versus UPVZ groups.

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Acknowledgements

The authors wish to acknowledge the valuable contributions of Jenna Cunningham and Dorothy Ens (research assistants) and Monica Ruff (research coordinator).

Funding

This study was funded by an investigator-initiated grant from AbbVie Corporation, Montreal, Canada. The CARESS registry is registered under: ClinicalTrials.gov Identifier: NCT00420966.

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Authors and Affiliations

  1. Department of Paediatrics, Alberta Children’s Hospital, University of Calgary, 2888 Shaganappi Trail NW, Calgary, AB, T3B 6A8, Canada

    Candice Bjornson & Ian Mitchell

  2. Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room FG-08, Toronto, ON, M4N3M5, Canada

    Parco Chan, Abby Li & Krista L. Lanctôt

  3. Department of Pharmacology/Toxicology, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Parco Chan & Krista L. Lanctôt

  4. Department of Paediatrics, McMaster University, Room–HSC-3A, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Bosco Paes

Authors
  1. Candice Bjornson
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  2. Parco Chan
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  3. Abby Li
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  4. Bosco Paes
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  5. Krista L. Lanctôt
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  6. Ian Mitchell
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Corresponding author

Correspondence to Candice Bjornson.

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Conflict of interest

CB received financial support from AbbVie International for travel to an international conference to present the findings of this study. A.L, B.P, I.M, and K.L. have received investigator initiated research funding or received compensation as advisors or lecturers from AbbVie Corporation and MedImmune. PC has no conflicts of interest to declare. No honorarium, grant, or other form of payment was given to anyone to produce the manuscript.

Ethical approval

The study was approved by the research ethics board of the Alberta Children’s Hospital. The CARESS study was reviewed and approved by each site’s respective research ethics board for compliance with the Declaration of Helsinki principles and the standards of Good Clinical Practice.

Informed consent

Informed consent was obtained for the PVZ subjects by each of the 32 recruitment centers across Canada who participated in the CARESS project.

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Bjornson, C., Chan, P., Li, A. et al. Palivizumab prophylaxis for respiratory syncytial virus in infants with cystic fibrosis: is there a need?. Eur J Clin Microbiol Infect Dis 37, 1113–1118 (2018). https://doi.org/10.1007/s10096-018-3225-7

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  • DOI: https://doi.org/10.1007/s10096-018-3225-7

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