Does RSV Prevention Influence Later Asthma Onset?

Respiratory syncytial virus (RSV) prevention in otherwise healthy preterm infants likely has no effect on the presence of asthma at age 6 years, according to a new study.

For their study, the researchers assessed 429 infants born at 32 to 35 weeks of gestation between 2008 and 2010. Each infant had been randomly assigned to receive either pavilizumab for RSV immunoprophylaxis or placebo during the RSV season of their first year of life. Children were followed until age 6 years.
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A total of 395 (92%) participants completed the study. Findings indicated that parent-reported current asthma was present in 28 (14.1%) of 199 children in the RSV prevention arm and 47 (24.0%) of 196 children in the placebo arm, with an absolute risk reduction (ARR) of 9.9%. This difference was due to a difference in infrequent wheeze (12 [6.0%] of 199 vs 26 [13.4%] of 194; ARR 7.4%).

Similar proportions of children with current physician-diagnosed asthma were observed in both groups (19 [10.3%] of 185 vs 18 [9.9%] of 182), with an ARR of -0.4. Between-group forced expiratory volume in half of a second (FEV_0·5) percentage predicted values were also similar (89.1% vs 90.1%), with a mean difference of 1.0.

“In otherwise healthy preterm infants, this single-blind, randomized, placebo-controlled trial showed that RSV prevention did not have a major effect on current asthma or lung function at age 6 years,” the researchers concluded. “Future research will inform on the effect of RSV prevention on asthma at school age in the general population.”

 —Christina Vogt

Reference:

Scheltema NM, Nibbelke EE, Pouw J, et al. Respiratory syncytial virus prevention and asthma in healthy preterm infants: a randomised controlled trial [Published online February 27, 2018]. Lancet Respir Med. https://doi.org/10.1016/S2213-2600(18)30055-9.