1200 Caress: The Canadian Registry of Synagis (2006-2009)

Abstract

Objective: To determine current usage of palivizumab prophylaxis, compliance patterns, hospitalization rate (HR) and outcomes in children at high-risk of respiratory syncytial virus (RSV) infection through a Canadian Registry Database (CARESS). Methods: A prospective, study of Canadian infants who received palivizumab in the 2006-2009 RSV seasons across 27 sites. Neonatal and demographic data were collected upon enrolment. Parents/ caregivers were contacted monthly for data on palivizumab utilization, compliance and outcomes related to any respiratory tract events. Results: 4926 infants aged 2 days - 47 months (mean=5.4 months) were enrolled. Participants were typically male (57.1%) and Caucasian (70.8%). Gestational age (GA) was 32.2 ± 4.6 completed weeks. 3480 (70.6%) premature infants received palivizumab (≤35 completed weeks GA), 403 (8.2%) required O2, 471 (9.6%) had congenital heart disease and 572 (11.6%) were prophylaxed for other risk factors. On average patients received 3.7 ± 1.5 injections, with 17,982 doses given overall. There were no drug related serious adverse events.296 infants required 357 hospitalizations for respiratory tract infections with a hospitalization rate of 6.0%. There were significant differences between indications for palivizumab (chi-square=71.8, p< 0.005). The overall RSV positive HR was 1.38%. Hospitalization rates were highest in infants of aboriginal descent (15.0%, chi-square = 22.2, p< 0.005). Hospitalized infants had a lower percentage of compliant injections (62.8% vs 68.6%, p=0.003). Conclusions: The RSV HR in the 2006-2009 RSV seasons resembled several published reports (range 1.3%-5.3%). RSV HR may be decreasing because of compliance with palivizumab prophylaxis, variability in RSV epidemiology, hospital admission criteria and preventive education.