Until last year, there was no widespread prevention strategy against respiratory syncytial virus (RSV), the main cause of childhood bronchiolitis, resulting in millions of children being admitted to pediatric intensive care units (PICUs) each year. Ta.
Last year, a prenatal maternal vaccine (Avrexy) and a long-lasting monoclonal antibody called nirsevimab were approved for use in the United States. Both products are intended to provide infants with passive immunization against RSV, and nilsevimab is approved for children at high risk of complications from RSV through the second year of life.
Trials showed that nirsevimab and ablexy were 83% and 67% effective, respectively, in preventing hospitalization.
In a new study published in JAMA Network Open, the authors estimate the impact these treatments have on reducing the total number of PICU admissions per year.
The authors were based on estimates of RSV-infected and uninfected patients in U.S. pediatric ICUs from January 1, 2017 to June 1, 2023. A total of 11,782 ICU cases from 53 hospitals were included in the analysis. The mean age of the patients was 4.5 years, and the mean length of hospital stay was 1.8 (1.0–3.9) days.
Approximately 11% (13,702) of visits were due to RSV, which accounted for 21.1% of total ICU days. Of the 13,702 patients who presented with RSV, 5,217 (38.6%) were eligible for RSV prophylaxis. Looking at children under 2 years of age, 16.6% of hospitalizations were due to RSV.
Likelihood of 4.4% reduction in ICU encounters
The authors found a combined efficacy of 75% representing both nirsevimab (83.2% efficacy) and the alexi vaccine (63.7% efficacy) in preventing hospitalization, compared to a nationwide 65% of maternal vaccines or infant antibodies. Using an uptake rate of 85%, we estimated a protective efficacy of 4.4%. 9.2% of ICU encounters and ICU days represented encounters with RSV-infected individuals currently targeted for RSV prophylaxis.
This result suggests that efforts to increase the availability and acceptance of these treatments are warranted.
“This result suggests that efforts to increase the availability and acceptance of these treatments are warranted,” the authors wrote.
In a commentary on the study, two Spanish researchers wrote that the study’s results show that “recently approved RSV prevention strategies have improved the epidemiology of RSV bronchiolitis as we currently know it and the utilization of the healthcare system in relation to it.” “This supports growing evidence that this could be a game-changer.”
“The upcoming respiratory season will be closely monitored and appropriate measures will be taken to enable context-specific, evidence-based policy decisions about which RSV prevention strategies should be prioritized for which specific populations. analysis needs to be performed,” the researchers wrote.
