The New England Journal of MedicineNirsevimab and Hospitalization for RSV Bronchiolitis

Monoclonal Antibody Therapy Shows Promise in Reducing RSV-Related Infant Hospitalizations, Potentially Impacting Pediatric Healthcare

A recent study published in the New England Journal of Medicine evaluated the real-world effectiveness of nirsevimab, a monoclonal antibody with an extended half-life, in preventing hospitalizations due to respiratory syncytial virus (RSV)-associated bronchiolitis in infants. The research provides crucial insights into the potential of nirsevimab as a preventive measure against a leading cause of infant hospitalizations worldwide.

Study Design:

• Prospective, multicenter, matched case-control study
• Included 1,035 infants younger than 12 months of age
• 690 case patients hospitalized for RSV-associated bronchiolitis
• 345 matched control patients with clinical visits unrelated to RSV infection
• Conducted between October 15 and December 10, 2023
• Case patients matched 2:1 with control patients based on age, date of hospital visit, and study center

Key Findings:

• Overall adjusted effectiveness of nirsevimab against hospitalization for RSV-associated bronchiolitis: 83.0% (95% CI, 73.4 to 89.2)
• Effectiveness against RSV-associated bronchiolitis resulting in critical care: 69.6% (95% CI, 42.9 to 83.8)
• Effectiveness against RSV-associated bronchiolitis requiring ventilatory support: 67.2% (95% CI, 38.6 to 82.5)
• 8.7% of case patients and 28.1% of control patients had previously received nirsevimab
• Sensitivity analyses corroborated the primary analysis results

HCN Medical Memo
Although the study shows promising results for nirsevimab in preventing RSV-associated hospitalizations, it’s important to consider the potential impact on clinical practice and public health strategies. Physicians should stay informed about ongoing research and guidelines regarding nirsevimab use, particularly in high-risk infant populations. The significant reduction in hospitalizations and critical care admissions suggests that nirsevimab could play a crucial role in managing the burden of RSV infections on healthcare systems.

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