Treatment with palivizumab was not associated with improved long-term outcomes in children with cystic fibrosis (CF), according to the results of a retrospective study published in Pediatrics.
Investigators used longitudinal data from the CF Foundation Patient Registry from 2008 to 2016 to evaluate the link between receiving palivizumab during the first 2 years of life and 3 longitudinal outcomes among pediatric patients with CF: lung function at 7 years of age, as assessed by the annualized percent of forced expiratory volume in 1 second (FEV1) predicted; time to first positive Pseudomonas aeruginosa respiratory culture during the first 7 years of life; and age-specific annual number of hospitalizations for pulmonary-related exacerbations or other complications during the first 8 years of life. Children eligible for the study were born between 2008 and 2015 and were diagnosed with CF during the first 6 months of life. In their analysis, the researchers explored demographic and clinical confounders of the association between receiving palivizumab and patient outcomes. Propensity scores were used to adjust for any potential confounders.
A total of 4267 infants were included in the study. Overall, a median of 37% (1588 of 4267) of these children were treated with palivizumab. The mean percent of FEV1 predicted at 7 years of age was similar between children who received palivizumab (98.2; 95% CI, 96.9-99.5) and those who did not receive palivizumab (97.3; 95% CI, 96.1-98.5), adjusted for propensity scores.
The time to first positive P aeruginosa culture and annual risk for exacerbation-related hospitalization were similar between those who were and those who were not treated with palivizumab.
The investigators concluded that an appropriate next step in this analysis would be to evaluate outcomes associated with palivizumab treatment among high-risk infants by including a prospective study within the CF Foundation Patient Registry. In addition, they recommended the development of concise case definitions for chronic lung disease and nutritional compromise for young children with CF. Outcomes could then be tracked with the use of current palivizumab data.
Fink AK, Graff G, Byington CL, Loeffler DR, Rosenfeld M, Saiman L. Palivizumab and long-term outcomes in cystic fibrosis.Pediatrics. 2019;144(1).