717. Cumulative Incidence of Asthma/Wheezing among Neonates/Infants/Toddlers Clinically Diagnosed with Respiratory Syncytial Virus Infection in the United States: a Retrospective Database Analysis.
Session: Poster Abstract Session: Respiratory Infections: Viral
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • 1110982 Asthma Wheezing.e-poster.jpg (3.0 MB)
  • Background: The role of respiratory syncytial virus (RSV) in the development of asthma/wheezing (AW) has been evaluated in several studies, mostly among pre-term infants or among infants after developing severe RSV-related disease. We describe the cumulative incidence (CI) of AW among hospitalized/ambulatory neonates/infants/toddlers after RSV/bronchiolitis infection diagnosis, in a large clinical database.

    Methods: Using de­identified Optum Integrated commercial claims and electronic medical records, we identified patients (0-<3 years old) with a first clinical diagnosis of RSV/bronchiolitis infection from 01January2008 – 31March2016. Patients with a diagnosis of asthma/wheezing ≤30 days after first RSV/bronchiolitis diagnosis were excluded. Three cohorts were created with 1/3/5 years of follow-up time required, respectively. Patients were grouped by specific high-risk factors (HRF+/-), including pre-term births and predefined pre-existing disease. Descriptive statistics are reported, with comparisons made by logistic regression analyses.

    Results: 9,811/4,524/1,788 patients with RSV/bronchiolitis infection and HRF- were included in the 1/3/5-years follow-up cohorts. 14.9%/28.2%/36.3% had AW events by the end of follow-up in the 3 cohorts. 6.5%/6.9%/5.8% were hospitalized for RSV/bronchiolitis.

    3,030/1,378/552 patients with RSV/bronchiolitis infection and HRF+ were included in the 1/3/5-years follow-up cohorts. 18.1%/32.9%/37.9% had AW events by the end of follow-up in the 3 cohorts. 11.4%/11.1%/11.6% were hospitalized for RSV/bronchiolitis.

    The CI rates of AW in the 1/3/5-year HRF+/- cohorts, stratified by hospitalized for RSV/bronchiolitis Y/N, are shown in Figure 1.

    Logistic regression confirmed that hospitalization for RSV/bronchiolitis was associated with an increased (p<0.05) likelihood of AW, for HRF+ and HRF- patients at each follow-up year.

    Conclusion: 38% of RSV/bronchiolitis infants/neonates/toddlers HRF+, and 36% among infants/neonates/toddlers HRF-, developed AW in the five years after first RSV/bronchiolitis diagnosis. RSV/bronchiolitis hospitalization was associated with a significantly increased risk of AW development in 1/3/5 years of follow-up; confirming previous observational study results.

    Veronique Wyffels, PharmD1, Maartje Smulders, MSc2, Sandra Gavart, MSc MBA1, Debasish Mazumder, PhD3, Rohit Tyagi, MPH3, Nikhil Gupta, BTech3 and Roman Fleischhackl, MD4, (1)Janssen Pharmaceutica NV, Beerse, Belgium, (2)SmartAnalyst, New York City, NY, (3)SmartAnalyst, Gurgaon, India, (4)Janssen-Cilag, Vienna, Austria

    Disclosures:

    V. Wyffels, Janssen: Employee , Salary .

    M. Smulders, SmaertAnalyst: Consultant , Consulting fee .

    S. Gavart, Janssen: Employee , Salary .

    D. Mazumder, SmartAnalyst: Consultant , Consulting fee .

    R. Tyagi, SmartAnalyst: Consultant , Consulting fee .

    N. Gupta, SmartAnalyst: Consultant , Consulting fee .

    R. Fleischhackl, Janssen: Employee , Salary .

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.