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Effectiveness of Palivizumab against Respiratory Syncytial Virus: Cohort and Case Series Analysis.
Moore, Hannah C; de Klerk, Nicholas; Richmond, Peter C; Fathima, Parveen; Xu, Ruomei; Keil, Anthony D; Snelling, Thomas L; Strunk, Tobias.
Afiliação
  • Moore HC; Wesfarmers Center of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia. Electronic address: hannah.moore@telethonkids.org.au.
  • de Klerk N; Wesfarmers Center of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia.
  • Richmond PC; Wesfarmers Center of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia; Perth Children's Hospital; Division of Pediatrics, School of Medicine, University of Western Australia.
  • Fathima P; Wesfarmers Center of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia.
  • Xu R; Wesfarmers Center of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia.
  • Keil AD; PathWest Laboratory Medicine WA, Perth, Western Australia, Australia.
  • Snelling TL; Wesfarmers Center of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia; Perth Children's Hospital; Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; School of Public Health, Curtin University.
  • Strunk T; Center for Neonatal Research and Education, University of Western Australia; Neonatal Directorate, King Edward Memorial Hospital, Perth, Western Australia.
J Pediatr ; 214: 121-127.e1, 2019 11.
Article em En | MEDLINE | ID: mdl-31378522
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. 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. 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. 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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vírus Sincicial Respiratório Humano / Infecções por Vírus Respiratório Sincicial / Palivizumab Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: Oceania Idioma: En Revista: J Pediatr Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vírus Sincicial Respiratório Humano / Infecções por Vírus Respiratório Sincicial / Palivizumab Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child, preschool / Female / Humans / Infant / Male / Newborn País/Região como assunto: Oceania Idioma: En Revista: J Pediatr Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos