Access to palivizumab among children at high risk of respiratory syncytial virus complications in English hospitals.
Access to palivizumab among children at high risk of respiratory syncytial virus complications in English hospitals.
复制标题
英国医院呼吸道合胞病毒并发症高危儿童获得帕利珠单抗。
DOI：
10.1111/bcp.15069
复制
发表时间：
2022
影响因子：
3.4
通讯作者：
Zylbersztejn A
中科院分区：
文献类型：
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作者：
Zylbersztejn A
AimsPalivizumab 是一种单克隆抗体，可以预防呼吸道合胞病毒（RSV）感染。由于成本较高，仅建议高危婴儿使用。我们的目的是确定英格兰符合帕利珠单抗治疗条件并接受至少一剂剂量的婴儿的比例。方法我们使用 Hospital Treatment Insights 数据库，该数据库包含英格兰 153 家医院中 43 家医院中与医院药房配药数据相关的入院记录。 2010 年至 2016 年间出生的婴儿，如果其病历显示患有慢性肺病 (CLD)、先天性心脏病 (CHD) 或严重免疫缺陷 (SCID)，并且符合基于出生时胎龄和 RSV 季节开始时（10 月初）年龄的其他标准，则被认为有资格接受帕利珠单抗治疗。我们计算了在第一个 RSV 季节中接受至少一剂帕利珠单抗的婴儿的比例，并使用逻辑回归模型根据多个儿童特征对治疗几率进行建模。结果我们确定了 3712 名符合条件的儿童，其中 2479 名 (67%) 拥有所有危险因素的完整信息。 832 名符合条件的儿童 (34%) 接受了帕利珠单抗治疗。妊娠 <30 周出生、RSV 季节开始时年龄 <6 个月以及患有两种或两种以上 CLD、CHD 或 SCID 的患者接受治疗的几率较高。结论在英格兰，大多数有资格接受帕利珠单抗治疗的儿童并未开出帕利珠单抗处方。管理这些婴儿的医生可能不熟悉资格标准或受到其他考虑因素（例如成本）的限制。
AimsPalivizumab is a monoclonal antibody which can prevent infection with respiratory syncytial virus (RSV). Due to its high cost, it is recommended for high‐risk infants only. We aimed to determine the proportion of infants eligible for palivizumab treatment in England who receive at least one dose.MethodsWe used the Hospital Treatment Insights database, which contains hospital admission records linked to hospital pharmacy dispensing data for 43 out of 153 hospitals in England. Infants born between 2010 and 2016 were considered eligible for palivizumab if their medical records indicated chronic lung disease (CLD), congenital heart disease (CHD) or severe immunodeficiency (SCID), and they met additional criteria based on gestational age at birth and age at start of the RSV season (beginning of October). We calculated the proportion of infants who received at least one dose of palivizumab in their first RSV season, and modelled the odds of treatment according to multiple child characteristics using logistic regression models.ResultsWe identified 3712 eligible children, of whom 2479 (67%) had complete information on all risk factors. Palivizumab was prescribed to 832 of eligible children (34%). Being born at <30 weeks' gestation, aged <6 months at the start of RSV season, and having two or more of CLD, CHD or SCID were associated with higher odds of treatment.ConclusionIn England, palivizumab is not prescribed to the majority of children who are eligible to receive it. Doctors managing these infants may be unfamiliar with the eligibility criteria or constrained by other considerations, such as cost.