Palivizumab Case Study

Infants at High Risk for Developing RSV & Palivizumab
Background
Respiratory Syncytial Virus (RSV) is an acute viral infection and the common cause of bronchiolitis in infants and young children. RSV primarily occurs in the months of October to March and affects infants of approximately six months of age and generally under the age of twenty-four months. The purpose of the study was to determine the association of RSV-related hospitalization and non-compliance with palivizumab (Synagis) in commercially insured infants and was clearly conveyed by the researcher. palivizumab is monoclonal antibody administered to high-risk infants via the intramuscular injection monthly for a five-month period, usually from November to March. Stewart et. al

A Cox proportional hazard regression is a statistical analysis used to examine survival data. In this study’s case, the variables included were non-compliance, hospitalization, chronic lung disease, CHD, and gestational age. The results of this study were presented as hazard ratios for every independent variable. The study tested the results stability by performing a final model determining the correlation of population subsets. The final model was identified to determine any correlation between non-compliance and RSV-related hospitalizations in the specific population subsets. The population subsets included in the final study are subjects with CHD, subjects with CLD, subjects whose initial dose was received in October or November, subjects without an initial dose, subjects categorized by RSV season (October-April), and subjects categorized by month of

The higher compliant patients were found to be twins (31.3%) and had low birth weight (69.9%). Compliant subjects also had a higher rate of NICU stay at birth compared to the noncompliant subjects. During the post index period, approximately 164 subjects out of 5,003 total had at least one RSV-related hospitalization. Non-compliant subjects had more cases of RSV and (5.9%) RSV-related hospitalizations compared to (2.3%) compliant subjects. Most cases of RSV and RSV-related hospitalization occurred before the initial dose of palivizumab was administered, approximately 27% or 61 RSV-related hospitalizations. An uncommon result showed subjects with immunodeficiency state (0.65%) and subjects with cystic fibrosis (1.57%) to have an increased non-compliance and RSV-related hospitalization compared to compliant subjects. The cases that occurred before the initial dose were excluded in the main analysis