Seungyeon Kim, Young June Choe, Saram Lee, Ju Sun Heo
{"title":"帕利珠单抗对预防中晚期早产儿严重急性下呼吸道感染的影响：全国队列研究》。","authors":"Seungyeon Kim, Young June Choe, Saram Lee, Ju Sun Heo","doi":"10.3346/jkms.2024.39.e279","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants.</p><p><strong>Methods: </strong>This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7-35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP; October 2013-September 2016) and insurance period (IP; October 2016-March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation. Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models.</p><p><strong>Results: </strong>Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626-0.949, <i>P</i> = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season.</p><p><strong>Conclusion: </strong>The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"39 43","pages":"e279"},"PeriodicalIF":3.0000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557254/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of Palivizumab in Preventing Severe Acute Lower Respiratory Infection in Moderate-to-Late Preterm Infants: A Nationwide Cohort Study.\",\"authors\":\"Seungyeon Kim, Young June Choe, Saram Lee, Ju Sun Heo\",\"doi\":\"10.3346/jkms.2024.39.e279\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants.</p><p><strong>Methods: </strong>This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7-35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP; October 2013-September 2016) and insurance period (IP; October 2016-March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation. Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models.</p><p><strong>Results: </strong>Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626-0.949, <i>P</i> = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season.</p><p><strong>Conclusion: </strong>The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.</p>\",\"PeriodicalId\":16249,\"journal\":{\"name\":\"Journal of Korean Medical Science\",\"volume\":\"39 43\",\"pages\":\"e279\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-11-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557254/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Korean Medical Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3346/jkms.2024.39.e279\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Korean Medical Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3346/jkms.2024.39.e279","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Impact of Palivizumab in Preventing Severe Acute Lower Respiratory Infection in Moderate-to-Late Preterm Infants: A Nationwide Cohort Study.
Background: Respiratory syncytial virus (RSV) prophylaxis using palivizumab effectively reduces RSV-associated morbidity in preterm infants. In Korea, national insurance coverage for palivizumab was implemented in October 2016 for moderate-to-late preterm (MLPT) infants born during the RSV season (October-March) who have older siblings. However, no large-scale studies have investigated the changes in the incidence and risk of severe acute lower respiratory infections (ALRIs) after insurance coverage implementation for MLPT infants.
Methods: This large-scale retrospective cohort study used data from the Korean National Health Insurance Service between October 2013 and December 2019. MLPT infants (32 0/7-35 6/7 weeks of gestation) with older siblings were stratified into pre-insurance period (PIP; October 2013-September 2016) and insurance period (IP; October 2016-March 2019) groups based on the date of birth with respect to initial insurance palivizumab implementation. Severe ALRI outcomes (hospitalization, respiratory support, and intensive care unit admission) were evaluated up to 1 year of age using multivariable logistic regression models.
Results: Of the 11,722 MLPT infants included in the study, 6,716 and 5,006 infants were included in the IP and PIP groups, respectively. The incidences of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in PIP group (24.0% vs. 26.0% and 3.1% vs. 4.0%, respectively). Additionally, ALRI-respiratory support risk was significantly lower in the IP group (adjusted odds ratio 0.771, 95% confidence interval 0.626-0.949, P = 0.014) than that in the PIP group. Among infants born during the RSV season, the risk of ALRI-hospitalization and ALRI-respiratory support were significantly lower in the IP group than that in the PIP group. However, no significant differences were observed between the IP and PIP groups for infants born during the non-RSV season.
Conclusion: The risks of severe ALRI outcomes decreased in Korea following the 2016 insurance implementation of palivizumab prophylaxis for MLPT infants born during the RSV season with older siblings.
期刊介绍：
The Journal of Korean Medical Science (JKMS) is an international, peer-reviewed Open Access journal of medicine published weekly in English. The Journal’s publisher is the Korean Academy of Medical Sciences (KAMS), Korean Medical Association (KMA). JKMS aims to publish evidence-based, scientific research articles from various disciplines of the medical sciences. The Journal welcomes articles of general interest to medical researchers especially when they contain original information. Articles on the clinical evaluation of drugs and other therapies, epidemiologic studies of the general population, studies on pathogenic organisms and toxic materials, and the toxicities and adverse effects of therapeutics are welcome.
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