title: Recombinant human deoxyribonuclease in infants with respiratory syncytial virus bronchiolitis.
abstract: BACKGROUND
  Treatment of hospitalized infants with respiratory syncytial virus (RSV) bronchiolitis is mainly supportive. Bronchodilators and systemic steroids are often used but do not reduce the length of hospital stay. Because hypoxia and airways obstruction develop secondary to viscous mucus in infants with RSV bronchiolitis, and because free DNA is present in RSV mucus, we tested the efficacy of the mucolytic drug recombinant human deoxyribonuclease (rhDNase).
  
  
  METHODS
  In a multicenter, randomized, double-blind, controlled clinical trial, 225 oxygen-dependent infants admitted to the hospital for RSV bronchiolitis were randomly assigned to receive 2.5 mg bid of nebulized rhDNase or placebo until discharge. The primary end point was length of hospital stay. Secondary end points were duration of supplemental oxygen, improvement in symptom score, and number of intensive care admissions.
  
  
  RESULTS
  There were no significant differences between the groups with regard to the length of hospital stay (p = 0.19) or the duration of supplemental oxygen (p = 0.07). The ratio (rhDNase/placebo) of geometric means of length of stay was 1.12 (95% confidence interval, 0.96 to 1.33); for the duration of supplemental oxygen, the ratio was 1.28 (95% confidence interval, 0.97 to 1.68). There were no significant differences in the rate of improvement of the symptom score or in the number of intensive care admissions.
  
  
  CONCLUSIONS
  Administration of rhDNase did not reduce the length of hospital stay or the duration of supplemental oxygen in oxygen-dependent infants with RSV bronchiolitis.
authors.affiliation: Department of Pediatric Pulmonology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherland. Electronic address: r.boogaard@erasmusmc.nl.
authors.forename: Ruben
authors.initials: R
authors.lastname: Boogaard
authors.affiliation: Department of Pediatrics, Amphia Hospital, Breda, Netherland.
authors.forename: Anthon R
authors.initials: AR
authors.lastname: Hulsmann
authors.affiliation: Reinier de Graaf Gasthuis, Delft, Netherland.
authors.forename: Leoniek
authors.initials: L
authors.lastname: van Veen
authors.affiliation: Department of Pediatrics, Amphia Hospital, Breda, Netherland.
authors.forename: Anja A P H
authors.initials: AAPH
authors.lastname: Vaessen-Verberne
authors.affiliation: Albert Schweitzer Hospital, Dordrecht, Netherland.
authors.forename: Yen Ni
authors.initials: YN
authors.lastname: Yap
authors.affiliation: HagaTeaching Hospital/Juliana Children's Hospital, the Hague, Netherland.
authors.forename: Arwen J
authors.initials: AJ
authors.lastname: Sprij
authors.affiliation: Medisch Centrum Alkmaar, Alkmaar, Netherland.
authors.forename: Govert
authors.initials: G
authors.lastname: Brinkhorst
authors.affiliation: Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Sibbles
authors.affiliation: Catharina Hospital, Eindhoven, Netherland.
authors.forename: Tom
authors.initials: T
authors.lastname: Hendriks
authors.affiliation: Sint Franciscus Gasthuis, Rotterdam, Netherland.
authors.forename: Sander W W
authors.initials: SWW
authors.lastname: Feith
authors.affiliation: Medisch Centrum Rijnmond Zuid, Rotterdam, Netherland.
authors.forename: Carsten R
authors.initials: CR
authors.lastname: Lincke
authors.affiliation: Medisch Centrum Rijnmond Zuid, Rotterdam, Netherland.
authors.forename: Annelies E
authors.initials: AE
authors.lastname: Brandsma
authors.affiliation: Isala Klinieken, Zwolle, Netherland.
authors.forename: Paul L P
authors.initials: PLP
authors.lastname: Brand
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus MC, Rotterdam, the Netherlands, Netherland.
authors.forename: Wim C J
authors.initials: WCJ
authors.lastname: Hop
authors.affiliation: Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherland.
authors.forename: Matthijs
authors.initials: M
authors.lastname: de Hoog
authors.affiliation: Department of Pediatric Pulmonology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherland.
authors.forename: Peter J F M
authors.initials: PJFM
authors.lastname: Merkus
mesh_terms: D000280:Administration, Inhalation; D001988:Bronchiolitis / Q000188:drug therapy*; D003850:Deoxyribonuclease I / Q000008:administration & dosage*; D004311:Double-Blind Method; D005100:Expectorants / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D008297:Male; D010102:Oxygen Inhalation Therapy; D010343:Patient Admission; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*; D018113:Respiratory Syncytial Virus, Human / Q000187:drug effects
chemical_list: D005100:Expectorants; C085693:DNASE1 protein, human; D003850:Deoxyribonuclease I