Palivizumab prophylaxis for respiratory syncytial virus in Canada: utilization and outcomes.
OBJECTIVE
To provide information on the use and outcomes of palivizumab prophylaxis in children at high risk of serious respiratory syncytial virus (RSV) infection.


METHODS
Observational, prospective, longitudinal, multicenter study.


METHODS
Eighteen hospitals and pediatric clinics located in six provinces across Canada.


METHODS
Infants enrolled in the palivizumab Special Access Programme of Canada's Therapeutic Products Programme throughout the 1999 to 2000 RSV season. Most were premature infants born at < or = 32 weeks of gestation and/or had bronchopulmonary dysplasia.


METHODS
Neonatal and demographic data were recorded for each subject. The parent/caregiver was contacted on a monthly basis until the end of the RSV season to obtain information on palivizumab utilization and compliance as well as incidence and severity of respiratory infections.


RESULTS
There were 444 evaluable subjects who each received 1 to 7 injections of palivizumab for a total of 1702 doses from September 1999 to April 2000. Most subjects received 5 injections with high compliance. Prophylaxis was discontinued in 2% of children. There were 116 clinical events or hospitalizations involving respiratory tract infections reported in 91 children. Eighty-six of these were managed in an outpatient setting, and 30 required hospitalization. The estimated incidence of hospitalization for RSV-positive lower respiratory tract infections (LRTIs) was 2.4%. Hospitalization for RSV LRTI occurred more often in children with bronchopulmonary dysplasia (6.0%) than in those with prematurity only (1.6%).


CONCLUSIONS
This study demonstrates that prophylaxis with palivizumab during the RSV season was associated with a low rate of hospitalization for RSV-positive LRTIs. Palivizumab was well-tolerated, and compliance was high. The findings confirm the results of the major randomized clinical trial of palivizumab and demonstrate the safety and effectiveness of RSV prophylaxis.
HOPE Research Centre, Sunnybrook, and Women's College Health Sciences Centre, University of Toronto, Ontario, Canada. paul.oh@swchsc.on.ca
Paul I
PI
Oh
Krista L
KL
Lanctôt
Alice
A
Yoon
David S C
DS
Lee
Bosco A
BA
Paes
Brian S
BS
Simmons
Diana
D
Parison
Patricia
P
Manzi
D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000473:pathology; D002170:Canada; D003710:Demography; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D000069455:Palivizumab; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy / Q000517:prevention & control*; D012136:Respiratory Syncytial Viruses / Q000187:drug effects; D012307:Risk Factors; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab