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

Arne Simon1, Susanne Gehrmann2, Gudrun Wagenpfeil3

  • 1Department of Pediatric Oncology and Hematology, Children's Hospital Medical Center, University Hospital of Saarland, Homburg, Germany. Arne.Simon@uks.eu.

European Journal of Pediatrics
|April 14, 2018
PubMed

Insights

Infants with Down syndrome (DS) have higher risks for respiratory infections. Palivizumab prophylaxis is effective in this population, despite increased comorbidities like congenital heart disease.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Genetics

Background:

  • Infants with Down syndrome (DS) are at increased risk for respiratory tract infections.
  • DS is an independent risk factor for complicated respiratory syncytial virus (RSV) infection in infants.
  • Palivizumab prophylaxis is used to prevent RSV in high-risk infants.

Purpose of the Study:

  • To analyze differences in risk factors and outcomes for infants with DS receiving palivizumab prophylaxis.
  • To assess the field effectiveness of palivizumab in infants with DS during RSV seasons.

Main Methods:

  • Prospective observational study of 249 infants with DS receiving palivizumab prophylaxis in Germany (2009-2016).
  • Data collected on gestational age, birth weight, comorbidities, and RSV-related hospitalizations.
  • Comparison of characteristics and outcomes between infants with and without DS.

Main Results:

  • Infants with DS had significantly lower gestational age and birth weight compared to those without DS.
  • Patients with DS more frequently had congenital heart disease, siblings in school, home oxygen use, immunodeficiency, and neuromuscular impairment.
  • RSV-related hospitalization rates were 1.20% in infants with DS and 0.71% in infants without DS, a non-significant difference in breakthrough cases.

Conclusions:

  • Significant differences exist in risk factors and indications for palivizumab use between infants with and without DS.
  • Palivizumab prophylaxis demonstrates field effectiveness in infants with DS.
  • Despite increased comorbidities, RSV-related hospitalization rates were not significantly higher in infants with DS experiencing breakthrough infections.

Keywords:
BronchiolitisDown syndromePalivizumab prophylaxisRSV-related hospitalizationRespiratory syncytial virus

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