Evidence map›Paper›PMID 39314944›Full record

ArticlemedRxiv : the preprint server for health sciences2024

Real-World Effectiveness of Nirsevimab Against Respiratory Syncytial Virus: A Test-Negative Case-Control Study.

Hanmeng Xu, Camilla Aparicio, Aanchal Wats, Barbara L Araujo, Virginia E Pitzer, Joshua L Warren, Eugene D Shapiro, Linda M Niccolai, Daniel M Weinberger, Carlos R Oliveira

Abstract readPreprint
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hanmeng XuDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Camilla AparicioDepartment of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, CT, USA.
Aanchal WatsDepartment of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, CT, USA.
Barbara L AraujoDepartment of Pediatrics, Section of Infectious Diseases and Global Health, Yale School of Medicine, New Haven, CT, USA.
Virginia E PitzerDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Joshua L WarrenDepartment of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
Eugene D ShapiroDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Linda M NiccolaiDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Daniel M WeinbergerDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Carlos R OliveiraDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.ORCID 0000-0003-1897-6581

Funding

Real-World Effectiveness of Perinatal RSV ImmunoprophylaxisR01AI179874 · NIAID · YALE UNIVERSITY · PI Carlos Rafael Oliveira · 2024 to 2026
$2.5M
Clinical Epidemiology of Pediatric COVID-19 and MIS-CK23AI159518 · NIAID · YALE UNIVERSITY · PI OLIVEIRA, CARLOS RAFAEL · 2021 to 2024
$729k
NIAID NIH HHS K23 AI159518NIAID NIH HHS R01 AI179874
6 · The paper itself

Abstract

importanceNirsevimab, a long-acting monoclonal antibody, has demonstrated efficacy against RSV-related lower respiratory tract infections (LRTIs) in clinical trials. Post-licensure monitoring is essential to confirm these benefits in real-world settings.

objectiveTo evaluate the real-world effectiveness of nirsevimab against medically attended RSV infections in infants and to assess how effectiveness varies by disease severity, dosage, and time since immunization. DESIGN SETTING AND

participantsThis test-negative case-control study used inpatient, outpatient, and emergency room data from the Yale New Haven Health System. Nirsevimab-eligible infants who were tested for RSV using polymerase chain reaction between October 1, 2023 and May 9, 2024 were included. Cases were infants with confirmed RSV infections; controls were those who tested negative. EXPOSURE: Nirsevimab immunization, verified through state immunization registries. MAIN OUTCOMES AND MEASURES: Effectiveness was estimated using multivariable logistic regression, adjusting for age, calendar month, and individual risk factors. Separate models examined effectiveness by clinical setting, disease severity, dose, and time since immunization. Broader outcomes, including all-cause LRTI and LRTI-related hospitalization, were also analyzed, with stratification by early and late respiratory seasons.

resultsThe analytic sample included 3,090 infants (median age 6.7 months, IQR 3.6-9.7), with 680 (22.0%) RSV-positive and 2,410 (78.0%) RSV-negative. 21 (3.1%) RSV-positive and 309 (12.8%) RSV-negative infants received nirsevimab. Effectiveness against RSV infection was 68.4% (95% CI, 50.3%-80.8%). Effectiveness was 61.6% (95% CI, 35.6%-78.6%) for outpatient visits and 80.5% (95% CI, 52.0%-93.5%) for hospitalizations. The highest effectiveness, 84.6% (95% CI, 58.7%-95.6%), was observed against severe RSV outcomes requiring ICU admission or high-flow oxygen. Although effectiveness against RSV infections declined over time, it remained significant at 55% (95% credible interval, 16%-75%) at 14 weeks post-immunization. Protective effectiveness was also observed against all-cause LRTI and LRTI-related hospitalizations during peak RSV season (49.4% [95% CI, 10.7%-72.9%] and 79.1% [95% CI, 27.6%-94.9%], respectively). However, from February to May, when RSV positivity was low, effectiveness against these broader outcomes was negligible. CONCLUSIONS AND RELEVANCE: Nirsevimab provided substantial protection against RSV-related outcomes for at least three months. These findings support the continued use of nirsevimab and provide evidence that may help build public confidence in the immunization program.

Identifiers

PMID39314944
PMCPMC11419242

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.