Palivizumab decreased recurrent wheeze for 1 year in preterm infants

Palivizumab treatment in otherwise healthy preterm infants decreased recurrent wheeze during the first year of life, according to recent study results published in The New England Journal of Medicine.

“We have shown that the administration of palivizumab for [respiratory syncytial virus] prevention reduced the total number of wheezing days in the first year of life among preterm infants with a gestational age of 33 to 35 weeks,” researchers wrote.

The double blind, placebo-controlled trial included 429 otherwise healthy preterm infants born at a gestational age of 33 to 35 weeks to receive palivizumab (Synagis, MedImmune) injections or placebo during the RSV season.

Researchers found that palivizumab treatment led to a 61% (95% CI, 56-65) relative reduction in wheezing days (1.8% of days for palivizumab vs. 4.5% of days for placebo). The effect of RSV prevention persisted during the post-prophylaxis period for a 73% (95% CI, 66-80) relative reduction.

They also found that the palivizumab group had a lower recurrence of wheezing compared with the placebo group (11.2% vs. 20.9%, respectively).

Among the children with proven RSV, there was no significant difference between the incidences of wheezing among the two groups (23% for palivizumab vs. 30% for placebo).

“The post-prophylaxis effect of RSV prevention on wheezing illness is evidence that RSV infection is an important mechanism in the pathogenesis of wheezing during the first year of life among late preterm infants,” researchers wrote.

Disclosure: The study was funded by Abbott Laboratories and by the Netherlands Organization for Health Research and Development. See the study for a full list of researchers’ financial disclosures.