Hospitalization for Respiratory Syncytial Virus Illness in Down Syndrome Following Prophylaxis With Palivizumab

Paes, Bosco; Mitchell, Ian; Yi, Hao; Li, Abby; Lanctôt, Krista L.

doi:10.1097/inf.0000000000000019

Cited by 27 publications

(21 citation statements)

References 27 publications

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“…Otherwise, DS with risk factors did not differ significantly from healthy DS (HR 3.1, 95%CI 0.6–17) in hazard to RSV‐related hospitalization. Hospitalization rates for RSV infection were similar for DS (1.53%), standard indications (1.45%), and other medical illnesses (2.27%), respectively …”

Section: Resultsmentioning

confidence: 89%

“…Three observational studies were included for this clinical question. All of them analyzed data from the Canadian Registry Database (CARESS), a prospective observational registry of palivizumab use and outcomes …”

Section: Resultsmentioning

confidence: 99%

“…All of them analyzed data from the Canadian Registry Database (CARESS), a prospective observational registry of palivizumab use and outcomes. 23,52,53 Paes et al compared the hospitalization rate for respiratory illness and RSV infection among 600 patients with Down syndrome (DS) who received palivizumab versus 11,081 children who received prophylaxis for standard indications and 1,629 subjects with other medical illnesses. Healthy DS children without any risk factors are still prone to acute respiratory illness hospitalizations and the rates increase significantly with associated risk factors such as insignificant CHD (HR 3.06, 95%CI 1.51-6.20) and hemodynamically significant CHD (HR 2.26, 95%CI 1.…”

Section: Efficacy Of Seasonal Prophylaxis With Palivizumab In Childrementioning

confidence: 99%

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Consensus conference on the appropriateness of palivizumab prophylaxis in respiratory syncytial virus disease

Pignotti

Leo

Pugi

et al. 2016

Pediatric Pulmonology

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Respiratory syncytial virus infection represents a clinical burden among young children under 24 months. Palivizumab is the only drug licensed in Italy for the prevention of serious lower respiratory tract disease requiring hospitalization caused by respiratory syncytial virus in children at high risk. However recommendations for palivizumab prophylaxis are heterogeneous. Not all the published documents agree about the clinical indications of palivizumab; this could lead to different clinical practices and concerns about the appropriateness of prophylaxis. These issues and the lack of evidence about palivizumab prophylaxis efficacy in specific medical conditions brought on the idea of a consensus conference on the current recommendations for the management and prevention of bronchiolitis, in order to share useful indications. The goal was to perform a review of the evidence regarding the efficacy and the safety of palivizumab and give recommendations in order to harmonize its use. A structured and validated method to conduct the consensus process was adopted. The consensus conference recommends palivizumab prophylaxis in infants born before 29 weeks and younger than 12 months at the start of the epidemic season. According to evidence from literature and experts' opinion, palivizumab prophylaxis is not recommended in preterm infants of gestational age ≥29 weeks, without co-morbidity (i.e., cardiac, bronchopulmonary diseases). The experts identified some clinical rare conditions for which the decision of prophylaxis should be entrusted to the specialists. The evaluation of the appropriateness of palivizumab prophylaxis in the single patient should be documented by the specialists. Pediatr Pulmonol. 2016;51:1088-1096. © 2016 Wiley Periodicals, Inc.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Efficacy Of Seasonal Prophylaxis With Palivizumab In Childrementioning

confidence: 99%

See 1 more Smart Citation

Consensus conference on the appropriateness of palivizumab prophylaxis in respiratory syncytial virus disease

Pignotti

Leo

Pugi

et al. 2016

Pediatric Pulmonology

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“…The CARESS registry identified 600 out of 13,300 children (having received at least one injection of palivizumab during the 2006 to 2012 RSV seasons in Canada) as having diagnosis of Down syndrome [26]. Compared to other indications of palivizumab prophylaxis RSV hospitalization rates were low in Down syndrome children below 2 years of age following prophylaxis (1.53% compared to 2.27%) and hazard ratios were similar to those found in other indications.…”

Section: Down Syndromementioning

confidence: 99%

“…T-cell immunodeficiency commonly presents with severe pulmonary disease and infants with severe congenital or acquired immune deficiency syndromes have been demonstratedto shed viruses for a prolonged time period. RSV related LRTI have been reported to result in increased morbidity and mortality [26]. RSV hospitalization rates have been observed to occur 3 to 10 times more often in these high risk populations.…”

Section: Neuromuscular Impairment and Immune Deficiency Syndromesmentioning

confidence: 99%

Respiratory Syncytial Virus Infection in High-risk Infants – an Update on Palivizumab Prophylaxis

Resch

2014

TOMICROJ

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Morbidity due to respiratory syncytial virus (RSV) disease is still high in infants and children worldwide during the first two to five years of life. Certain categories of high-risk infants with increased morbidity and mortality attributed to RSV disease have been identified and are included in national recommendations for prophylaxis with the monoclonal RSV antibody palivizumab. Most guidelines recommend palivizumab for preterm infants born less than or equal to 32 weeks gestational age with or without bronchopulmonary dysplasia, those born between 33 and 35 weeks gestational age with additional risk factors, and infants and children with hemodynamically significant congenital heart disease. Over the last years several rare diseases have been identified demonstrating high morbidity associated with RSV disease, thus, extension of guidelines for the prophylaxis with palivizumab for these patients with rare diseases including children with malignancy, congenital and acquired immune deficiency, Down syndrome, neuromuscular impairment, cystic fibrosis, congenital diaphragmatic hernia and other severe respiratory disease is increasingly discussed. Efficacy of palivizumab prophylaxis is documented by meta-analysis, and different economic analyses demonstrate cost-effectiveness of palivizumab for the most common indications during the first RSV season.

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Palivizumab use in infants with Down syndrome—report from the German Synagis™ Registry 2009–2016

et al. 2018

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Data from 249 children with DS receiving palivizumab prophylaxis in seven consecutive RSV seasons (2009-2016) in Germany reveal important differences between patients with and without DS concerning the main indication for palivizumab use and additional risk factors. Bearing in mind the limitations of an uncontrolled postmarketing observational study, the results confirm the field effectiveness of palivizumab prophylaxis in this special population. What is Known: • Recent studies describe the Down syndrome as independent risk factor for a complicated clinical course in infants with RSV infection. What is New: • Compared with other infants receiving palivizumab prophylaxis, patients with Down syndrome significantly more often had congenital heart disease, siblings in kindergarten or school, treatment with oxygen at home, immunodeficiency, and neuromuscular impairment. • In infants with palivizumab prophylaxis breakthrough, RSV-related hospitalization rates were not significantly higher in those with Down syndrome.

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Hospitalization for Respiratory Syncytial Virus Illness in Down Syndrome Following Prophylaxis With Palivizumab

Abstract: The proportion of DS children who received palivizumab in CARESS has increased almost 45-fold. RSVH rates were low in DS following prophylaxis and hazards were similar to those found in SI and MI.

Cited by 27 publications

References 27 publications

Consensus conference on the appropriateness of palivizumab prophylaxis in respiratory syncytial virus disease

Consensus conference on the appropriateness of palivizumab prophylaxis in respiratory syncytial virus disease

Respiratory Syncytial Virus Infection in High-risk Infants – an Update on Palivizumab Prophylaxis

Palivizumab use in infants with Down syndrome—report from the German Synagis™ Registry 2009–2016

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