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Comparing First- and Second-year Palivizumab Prophylaxis in Patients With Hemodynamically Significant Congenital Heart Disease in the CARESS Database (2005-2015).

Abstract Respiratory syncytial virus hospitalization (RSVH) rates in children <2 years of age with hemodynamically significant congenital heart disease (HSCHD) are 2- to 4-fold higher compared with healthy term infants. Pediatric recommendations differ as to whether palivizumab is beneficial beyond 1 year of age. The objective of this study was to determine whether differences exist in respiratory-related illness hospitalization (RIH) and RSVH in HSCHD infants receiving palivizumab during the first year versus second year of life in the Canadian Registry of Palivizumab.
PMID
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Comparing First- and Second-Year Palivizumab Prophylaxis in Patients with Hemodynamically Significant Congenital Heart Disease in the CARESS Database (2005-2015).

Authors

Mayor MeshTerms

Pre-Exposure Prophylaxis

Registries

Keywords
Journal Title the pediatric infectious disease journal
Publication Year Start




PMID- 28403044
OWN - NLM
STAT- MEDLINE
DA  - 20170413
DCOM- 20170420
LR  - 20170420
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 36
IP  - 5
DP  - 2017 May
TI  - Comparing First- and Second-year Palivizumab Prophylaxis in Patients With
      Hemodynamically Significant Congenital Heart Disease in the CARESS Database
      (2005-2015).
PG  - 445-450
LID - 10.1097/INF.0000000000001357 [doi]
AB  - BACKGROUND: Respiratory syncytial virus hospitalization (RSVH) rates in children 
      &lt;2 years of age with hemodynamically significant congenital heart disease (HSCHD)
      are 2- to 4-fold higher compared with healthy term infants. Pediatric
      recommendations differ as to whether palivizumab is beneficial beyond 1 year of
      age. The objective of this study was to determine whether differences exist in
      respiratory-related illness hospitalization (RIH) and RSVH in HSCHD infants
      receiving palivizumab during the first year versus second year of life in the
      Canadian Registry of Palivizumab. METHODS: The Canadian Registry of Palivizumab
      is a prospective database of infants who received &gt;/=1 dose of palivizumab in 32 
      hospitals from 2005 to 2015. Demographic data were collected at enrollment and
      RIH events recorded monthly. Infants &lt;24 months of age with HSCHD were recruited.
      RESULTS: Of 1909 HSCHD infants, 1380 (72.3%) in the first year (mean age, 4.2
      months) and 529 (27.7%) in the second year of life (mean age, 17.8 months)
      received prophylaxis. Baseline demographics for day-care attendance, multiple
      births, enrollment age and weight differed between the groups (all P &lt; 0.05).
      Additionally, second year infants had a more complicated neonatal course, with
      significantly longer length of stay (51.2 vs. 24.9 days) compared with those in
      the first year. The RIH and RSVH rates in the first year were 11.2% and 2.3% and 
      in the second year were 10.6% and 1.7%. Cox regression analysis showed similar
      hazard for RIH [hazard ratio, 1.9; 95% confidence interval: 0.7-4.6; P = 0.18]
      and RSVH [hazard ratio, 2.0; 95% confidence interval: 0.2-16.5; P = 0.52].
      CONCLUSIONS: Infants in the first and second year of life had a similar RSVH
      hazard. These findings suggest that infants in the second year with HSCHD, who
      remain unstable, are equally at risk for RSVH and merit prophylaxis.
FAU - Li, Abby
AU  - Li A
AD  - From the *Medical Outcomes and Research in Economics (MORE) Research Group,
      Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario,
      Canada; daggerDivision of Respirology, Department of Pediatrics, University of
      Calgary, Calgary, Alberta, Canada; and double daggerDivision of Neonatology,
      Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
FAU - Wang, Daniel Y
AU  - Wang DY
FAU - Lanctot, Krista L
AU  - Lanctot KL
FAU - Mitchell, Ian
AU  - Mitchell I
FAU - Paes, Bosco A
AU  - Paes BA
CN  - CARESS Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
RN  - 0 (Antiviral Agents)
RN  - DQ448MW7KS (Palivizumab)
SB  - IM
MH  - Antiviral Agents/*administration &amp; dosage
MH  - Birth Weight
MH  - Canada
MH  - Female
MH  - Heart Defects, Congenital/complications/immunology/pathology
MH  - Hemodynamics
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Length of Stay/statistics &amp; numerical data
MH  - Male
MH  - Palivizumab/*administration &amp; dosage
MH  - *Pre-Exposure Prophylaxis
MH  - Proportional Hazards Models
MH  - Prospective Studies
MH  - *Registries
MH  - Respiratory Syncytial Virus
      Infections/complications/immunology/pathology/*prevention &amp; control
MH  - Respiratory Syncytial Virus, Human/immunology/pathogenicity
MH  - Risk
EDAT- 2017/04/14 06:00
MHDA- 2017/04/21 06:00
CRDT- 2017/04/14 06:00
AID - 10.1097/INF.0000000000001357 [doi]
AID - 00006454-201705000-00001 [pii]
PST - ppublish
SO  - Pediatr Infect Dis J. 2017 May;36(5):445-450. doi: 10.1097/INF.0000000000001357.

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