Drummond David, Thumerelle Caroline, Reix Philippe, Fayon Michael, Epaud Ralph, Clement Annick, Mahloul Malika, Habouria Delphine, Delacourt Christophe, Hadchouel Alice
Service de Pneumologie et d'Allergologie Pédiatriques, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, 75015, Paris, France.
Université Paris-Descartes, Paris, France.
Pediatr Pulmonol. 2016 Jul;51(7):688-95. doi: 10.1002/ppul.23354. Epub 2015 Dec 4.
There is a lack of evidence concerning the effectiveness of immunoprophylaxis with palivizumab in children with childhood interstitial lung disease (chILD). In this retrospective study, we evaluated the effectiveness of palivizumab for decreasing the rate of RSV-related hospitalizations in children under the age of 24 months with chILD treated with corticosteroids.
A retrospective national study was conducted in France. Patients born between 2007 and 2013, diagnosed with chILD and on corticosteroid treatment were identified through the French online database for pediatric interstitial lung disease (Respirare(®) ). Data were collected for the etiology and severity of chILD, risk factors and preventive measures for bronchiolitis, palivizumab immunoprophylaxis, and hospitalizations for bronchiolitis and RSV-bronchiolitis.
We included and evaluated 24 children during their first two RSV seasons, corresponding to 36 patient-seasons. The observed rate of RSV-related hospitalization (305/1000 patient-seasons), and the median length of stay (7 days), were higher than those for the general population. RSV-related hospitalization rates did not differ significantly between children with and without palivizumab prophylaxis (5/16 vs. 4/18, respectively, P = 0.70).
Children with chILD on corticosteroid treatment are at high risk of hospitalization for RSV-bronchiolitis, which tends to be more severe in these children than in the general population. The effectiveness of palivizumab prophylaxis in this population remains to be demonstrated. Pediatr Pulmonol. 2016;51:688-695. © 2015 Wiley Periodicals, Inc.
关于帕利珠单抗免疫预防在儿童间质性肺病（chILD）患儿中的有效性，目前缺乏证据。在这项回顾性研究中，我们评估了帕利珠单抗在接受皮质类固醇治疗的24个月以下chILD患儿中降低呼吸道合胞病毒（RSV）相关住院率的有效性。
在法国进行了一项全国性回顾性研究。通过法国儿科间质性肺病在线数据库（Respirare®）识别出2007年至2013年出生、被诊断为chILD且正在接受皮质类固醇治疗的患者。收集了chILD的病因和严重程度、细支气管炎的危险因素和预防措施、帕利珠单抗免疫预防以及细支气管炎和RSV细支气管炎住院治疗的数据。
我们纳入并评估了24名儿童在前两个RSV季节的数据，相当于36个患者季节。观察到的RSV相关住院率（305/1000患者季节）和中位住院时间（7天）高于一般人群。接受和未接受帕利珠单抗预防的儿童之间，RSV相关住院率无显著差异（分别为5/16和4/18，P = 0.70）。
接受皮质类固醇治疗的chILD患儿因RSV细支气管炎住院的风险很高，且这种疾病在这些患儿中往往比一般人群更为严重。帕利珠单抗预防在该人群中的有效性仍有待证实。《儿科肺病学》。2016年；51:688 - 695。© 2015威利期刊公司
