RSV during infancy and childhood asthma: the puzzle remains

Scheltema NM, Nibbelke EE, Pouw J, Blanken MO, Rovers MM, Naaktgeboren CA, Mazur NI, Wildenbeest JG, van der Ent CK, Bont LJ. Respiratory syncytial virus prevention and asthma in healthy preterm infants: a randomised controlled trial. Lancet Respir Med. 2018 Feb 27; in press. Available from: doi: 10.1016/S2213-2600(18)30055-9.


A 6-year single-blind, randomised, placebo-controlled trial (MAKI) was carried out to evaluate the effect of RSV prevention during infancy on asthma and lung function at age 6 years. 429 infants born at 32-35 weeks of gestation (otherwise healthy) randomly received either palivizumab or placebo during RSV season of their first year of life and were followed up at age 6 years. This study indicated that RSV prevention in otherwise healthy preterm infants reduced the risk of parent-reported asthma at age 6 years, which was mainly explained by differences in infrequent wheeze. However, RSV prevention had no effect on the risk of physician-diagnosed asthma or lung function at age 6 years. The result of this study should be interpreted with caution due to potential information bias from parents, missing data for lung function, and limited power of the study. We should also be careful when generalising the results to term infants or lower income regions or assessing the impact of RSV prevention by using other immunisation strategies.

Abstract on Pubmed.