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Aboriginal Canadian infants taking Synagis remain at greater risk for RSV
Recent findings showed that Aboriginal Canadian infants receiving Synagis prophylaxis remained significantly more likely to develop respiratory syncytial virus and other respiratory-related illnesses compared with non-Aboriginal infants.
“The burden of RSV-related disease in Aboriginal infants has been documented [in previous studies],” Charles P.S. Hui, MD, FRCPC, in the department of pediatrics at the University of Ottawa, and colleagues wrote. “Our study has demonstrated that a disproportionate burden of RSV-related disease also exists in Aboriginal patients given [Synagis (palivizumab) MedImmune] prophylaxis.”
While Aboriginal infants carry a higher burden of RSV, this has not been studied for those taking palivizumab prophylaxis, which has been proven to reduce RSV severity in preterm infants, the researchers wrote. To determine if the burden remained the same for Aboriginal infants while taking palivizumab, Hui and colleagues performed a retrospective study of 19,235 infants, including 701 Aboriginals, who received palivizumab from 2005 to 2014. They also determined adherence by assessing the number of palivizumab doses received during RSV season and assessing the inter-dose time interval.
Among the patients taking palivizumab, Aboriginals were significantly more likely to suffer respiratory-related illness (HR = 1.4; 95% CI, 1.1-1.8). Data indicated that Aboriginal infants were 62.8% adherent with all recommended injections and 63.3% adherent within the dosing intervals, while non-Aboriginal infants were 81.9% injection-adherent and 72.4% adherent within dosing intervals. In addition, 39.9% of Aboriginals were adherent to both injections and time-intervals compared with 61.7% of non-Aboriginals. Aboriginals who were nonadherent with inter-dose intervals were more likely to suffer RSV-specific infection (HR =2.2; 95% CI 1.2-4.2).
Incomplete prophylaxis with palivizumab also has been shown to increase RSV-specific infection by 21% among the U.S. Medicaid population, the researchers wrote.
“Once a health care practitioner makes the recommendation for prophylaxis and the parents agree, the complex pathway of adherence begins,” the researchers wrote. “Improving adherence especially inter-dose frequency may further reduce hospitalizations in this vulnerable population.” – by Will Offit
Disclosure: Hui reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.