Related Experiment Video
Updated: May 6, 2026
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Effect of palivizumab prophylaxis on subsequent recurrent wheezing in preterm infants
Shigemi Yoshihara1, Satoshi Kusuda, Hiroyuki Mochizuki
1Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi, Japan 321-0293. shigemi@dokkyomed.ac.jp.
Insights
Palivizumab prophylaxis significantly reduced recurrent wheezing in preterm infants up to age 3. This respiratory syncytial virus (RSV) preventive measure offers long-term benefits for high-risk infants.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Infectious Disease Prevention
Background:
- Severe respiratory syncytial virus (RSV) disease is a significant concern for preterm infants.
- Palivizumab is an established prophylactic agent against severe RSV disease.
Purpose of the Study:
- To evaluate the long-term effect of palivizumab prophylaxis on recurrent wheezing in preterm infants.
- To determine if early RSV season prophylaxis impacts wheezing incidence up to three years of life.
Main Methods:
- An observational, prospective, multicenter case-control study involving preterm infants (33-35 weeks gestational age).
- Infants were followed for three years, with palivizumab administration based on standard practice during the first RSV season.
- Recurrent wheezing was assessed via physician diagnosis, report cards, and a mobile phone-based reporting system.
Main Results:
- Physician-diagnosed recurrent wheezing occurred in 6.4% of infants who received palivizumab versus 18.9% in the untreated group (P < .001).
- The observed difference remained statistically significant after adjusting for known risk factors for recurrent wheezing (P < .001).
Conclusions:
- Palivizumab prophylaxis in preterm infants (33-35 weeks' gestational age) is associated with a significantly lower incidence of recurrent wheezing.
- This suggests a protective effect of palivizumab beyond the immediate RSV season, extending to three years of life.
Background And Objectives:
Palivizumab effectively prevents severe respiratory syncytial virus (RSV) disease in preterm infants. Our objective was to test whether palivizumab prophylaxis given to preterm infants during the first RSV season reduces the incidence of subsequent recurrent wheezing up to 3 years of life.
Methods:
We conducted an observational prospective multicenter (52 registered hospitals in Japan) case-control study in preterm infants with a gestational age between 33 and 35 weeks followed for 3 years. During the 2007-2008 RSV season, the decision to administer palivizumab was made based on standard medical practice. In April 2008, 52 hospitals were recruited. Study participants were prospectively followed to the age of 3 years. Parents of study subjects reported the infants' physician's assessment of recurrent wheezing, used a report card and a novel mobile phone-based reporting system by using the Internet. The primary end point was the incidence of physician-diagnosed recurrent wheezing.
Results:
Of 444 preterm infants enrolled, 349 received palivizumab during the first 6 months of life and 95 infants did not. Physician-diagnosed recurrent wheezing was observed in 6.4% and 18.9% of infants in the treated and untreated groups, respectively (P < .001). This difference remained significant after adjustment for known risk factors of recurrent wheezing (P < .001).
Conclusions:
Palivizumab prophylaxis administered to preterm infants 33 to 35 weeks' gestational age is associated with a significantly lower incidence of recurrent wheezing during the first 3 years of life.
Related Concept Videos
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
01:13Asthma III: Clinical Manifestations
01:19Antiasthma Drugs: Leukotriene Modifiers
Leukotriene modifiers work through two distinct mechanisms:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:30Asthma-IV: Nursing Management
First, in...