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Published on: August 7, 2017
Palivizumab prophylaxis in preterm infants and subsequent wheezing/asthma: 10-year follow-up study
Masahiko Kato1,2, Hiroyuki Mochizuki1,2, Yuichi Kama1
1Department of Pediatrics, Tokai University School of Medicine, Isehara, Japan.
Insights
Palivizumab prophylaxis in preterm infants did not prevent recurrent wheezing or asthma by age 10. Maternal smoking and aeroallergen sensitization were linked to asthma development in children.
Area of Science:
- Pediatric Respiratory Medicine
- Immunology
- Public Health
Background:
- Respiratory syncytial virus (RSV) is a significant cause of infantile wheezing and asthma development.
- Preterm infants are at higher risk for severe RSV infections and subsequent respiratory issues.
- Understanding long-term impacts of RSV and its prevention is crucial for child respiratory health.
Purpose of the Study:
- To evaluate the long-term efficacy of palivizumab prophylaxis in preventing recurrent wheezing and asthma in preterm infants.
- To assess the impact of palivizumab at 10 years of age, extending previous 6-year follow-up data.
- To identify risk factors associated with asthma development in this cohort.
Main Methods:
- An observational, prospective, multicenter case-control study followed preterm infants (33-35 weeks gestation) for 10 years.
- Palivizumab administration was based on standard medical practice during the initial RSV season.
- Physician-diagnosed recurrent wheezing/asthma was reported via a novel mobile phone-based system.
Main Results:
- Palivizumab prophylaxis showed no significant difference in recurrent wheezing or asthma incidence at 10 years.
- Maternal smoking combined with aeroallergen sensitization was significantly correlated with physician-diagnosed asthma.
- No significant long-term benefit of palivizumab was observed in this cohort.
Conclusions:
- Palivizumab prophylaxis administered during infancy did not prevent recurrent wheezing or asthma development by age 10.
- Maternal passive smoking and aeroallergen sensitization represent significant risk factors for childhood asthma.
- Further research is needed to explore effective preventative strategies for RSV-related respiratory conditions.
Background:
Respiratory syncytial virus (RSV) causes not only infantile recurrent wheezing but also the development of asthma. To investigate whether palivizumab, an anti-RSV monoclonal antibody, prophylaxis given to preterm infants during the first RSV season reduces the incidence of subsequent recurrent wheezing and/or development of asthma, at 10 years of age.
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 6 years. During the 2007-2008 RSV season, the decision to administer palivizumab was made based on standard medical practice (SCELIA study). Here, we followed these subjects until 10 years of age. Parents of study subjects reported the patients' physician's assessment of recurrent wheezing/asthma, using a report card and a novel mobile phone-based reporting system using the internet. The relationship between RSV infection and asthma development, as well as the relationship between other factors and asthma development, were investigated.
Results:
Of 154 preterm infants enrolled, 113 received palivizumab during the first year of life. At 10 years, although both recurrent wheezing and development of asthma were not significantly different between the treated and untreated groups, maternal smoking with aeroallergen sensitization of the patients was significantly correlated with physician-diagnosed asthma.
Conclusions:
In contrast to the prior study results at 6 years, by 10 years palivizumab prophylaxis had no impact on recurrent wheezing or asthma, but there was a significant correlation between maternal passive smoking with aeroallergen sensitization and development of asthma by 10 years of age.
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