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Antibody against RSV helps prevent wheeze in infants

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f3089 (Published 15 May 2013) Cite this as: BMJ 2013;346:f3089

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Palivizumab is a monoclonal antibody directed against respiratory syncytial virus (RSV) and an effective prophylactic against severe infection in high risk infants. A new trial in preterm infants reports that the drug also helps prevent wheezing in the first year of life. Infants given up to five injections of palivizumab during the winter season wheezed on 61% fewer days than controls given placebo injections (1.8% (930/53 075) v 4.5% (2309/51 726); relative reduction 61%, 95% CI 56% to 65%). As expected, the active injections helped prevent RSV infections, although parents managed to take nasopharyngeal swabs during less than a third of respiratory episodes. Together, these findings implicate RSV as a direct cause of wheeze in infants born at 33-35 weeks of gestation, say the authors.

The 429 infants in this trial were otherwise healthy. They were no more than 6 months old at the start of their first RSV season and were recruited from hospital paediatric departments in the Netherlands. If preventing RSV also prevents wheeze in the first year of life, we might reasonably explore whether RSV prophylaxis can reduce the risk of persistent wheezing or asthma later in childhood, says a linked editorial (p 1839). The trial was funded jointly by Abbot Laboratories and the government of the Netherlands.

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Cite this as: BMJ 2013;346:f3089