Monoclonal antibody reduces wheezing in preterm babies, study finds

Monoclonal antibody reduces wheezing in preterm babies

According to a study published in The New England Journal of Medicine, pavilizumab, a monoclonal antibody given to prevent respiratory syncytial virus infection, has proven effective in reducing the number of days of wheezing in preterm babies. Researchers say that wheezing episodes in late preterm children are mostly caused by respiratory syncytial virus and that these episodes of wheezing can be prevented by administering pavilizumab.

To demonstrate the efficacy of this monoclonal antibody in preventing the infection with RSV, researchers conducted a study that included 400 children born between 33 and 35 weeks’ gestational, that is late preterm. They were randomized to receive either injections of pavilizumab or placebo injections. The drug was well tolerated and the only adverse reactions that occurred were redness and swelling at the injection site. The study showed that the number of days of wheezing decreased to 60% among children who received injections with pavilizumab. In addition, it seems that the effect lasted even after cessation of treatment. Dr. Robert Lemanske Jr., a professor of pediatrics and medicine at the University of Wisconsin School of Medicine and Public Health in Madison, said that in preterm babies, RSV infections are a risk factor for wheezing and that this treatment reduces this risk.

Pavilizumab

Lead author Dr. Louis Bont, a pediatric infectious disease specialist at the University Medical Center Utrecht in the Netherlands, explained that RSV is a major health problem among preterm infants in the first year of life and it is the second cause of death after malaria. He added that if in healthy late pre-term, RSV is associated with 5% hospitalization, for others preterm babies the rate is higher. Moreover, nearly half of the healthy preterm babies develop wheezing illness.

RSV infection in the first year of life leads to wheezing and this in turn leads to the development of asthma later in life. Therefore, RSV infection is associated with long-term consequences. Bont wanted to clarify that it is not known yet if pavilizumab will also decrease the risk of asthma. According to the U.S. Centers for Disease Control and Prevention, RSV infection lasts for several months per year, four or five months, in winter and spring, but in America the exact timing varies depending on the region. It should be noted that there is no vaccine to protect against this virus and that in older children and adults RSV gives mild symptoms. In preterm babies however it is an important cause of morbidity and mortality.

The only drawback is that this treatment is quite expensive: it can reach up to 10,000 dollars per season in America. Although Bont believes pavilizumab should become the standard treatment for preterm babies during RSV season, he nevertheless highlights that: “Society needs to define whether its cost-effectiveness is acceptable”.