Objective: To evaluate the effect of recombinant human
deoxyribonuclease I (rhDNase) in shortening the length of the
hospitalization and improving the chest radiographs (CXRs) in
hospitalized infants with respiratory syncytial virus (RSV) infection
as a result of its mucolytic properties.
Randomized, double-blind, placebo-controlled investigation of 75
patients with RSV bronchiolitis. The study was conducted at the
University of Michigan Medical Center and St. Joseph Mercy Hospital,
both in Ann Arbor, MI.
Results: The respiratory rate,
wheezing, and retraction difference scores, obtained by subtracting the
hospital discharge score from the corresponding hospital admission
score, show no difference between the two groups, but the CXR
difference scores show that the rhDNase group improved by 0.46 while
the placebo group worsened by 0.60 (p < 0.001). Analysis of
covariance for the hospital discharge CXR score after adjusting for the
hospital admission score for both groups was done. There was a
difference in scores between the two groups, with adjusted mean for the
study group of 2.03, and 2.76 for the placebo group (p < 0.001).
Paired t test statistics in each of the two groups were
computed. For the placebo group, the mean increase of 0.60 was
significant (p = 0.02), and the mean decrease of 0.46 for the rhDNase
group was also significant (p = 0.02). A one-way analysis of
covariance with the hospital discharge CXR scores as the dependent
variable and the hospital admission score as the covariate showed that
there was a significant difference between the groups
(p = 0.01).
Conclusion: In patients with RSV
bronchiolitis, there was significant improvement in the CXRs with the
use of rhDNase compared to significant worsening in the placebo group.
To our knowledge, this is the first report of the use of rhDNase to
treat RSV bronchiolitis.