Paediatric cystic fibrosis: palivizumab is not linked to long-term benefit

  • Pediatrics

  • International Clinical Digest
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Takeaway

  • Among children with cystic fibrosis (CF), palivizumab is not linked to any improvements in longer-term outcomes, including lung function at age 7 years or pulmonary hospitalisation rates.

Why this matters

  • Guidelines recommend palivizumab be considered only for infants who show evidence of nutritional compromise or chronic lung disease.

Key results

  • Predicted mean percent FEV1 was similar between children at age 7 years, regardless of history of receiving palivizumab. 
    • 98.2 (95% CI, 96.9-99.5) with drug vs 97.3 (95% CI, 96.1-98.5) without.
  • These 2 groups also did not differ in annual hospitalization risk or time to first positive Pseudomonas aeruginosa culture.
  • Infants who received palivizumab were likelier to have a profile of lower height/weight percentiles, birth at 37 weeks, meconium at birth, pancreatic enzyme replacement therapy, and asthma.

Study design

  • Data from Cystic Fibrosis Foundation Patient Registry analyzed for 4267 infants (37% received palivizumab) born 2008-2015, diagnosed with CF at age ≤6 months.
  • Funding: No external funding.

Limitations

  • Usual limitations of registry-based, observational studies.
  • Almost a third of original cohort excluded because of missing data.