Efficacy of recombinant human deoxyribonuclease I in the hospital management of respiratory syncytial virus bronchiolitis

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 syncytia l virus (RSV) infection as a result of its mucolytic properties. Methods: Randomized, double-blind, placebo-controlled investigation of 75 p atients with RSV bronchiolitis, The study was conducted at the University o f 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 t he 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 admissio n 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 fo r the placebo group (p < 0.001). Paired t test statistics in each of the tw o groups were computed, For the placebo group, the mean increase of 0.60 wa s significant (p = 0.02), and the mean decrease of 0.16 for the rhDNase gro up was also significant (p = 0.02), A one-way analysis of covariance with t he hospital discharge CXR scores as the dependent variable and the hospital admission score as the covariate showed that there was a significant diffe rence between the groups (p = 0.01). Conclusion: In patients with RSV bronchiolitis, there was significant impro vement in the CXRs with the use of rhDNase compared to significant worsenin g in the placebo group. To our knowledge, this is the first report of the u se of rhDNase to treat RSV bronchiolitis.