• Solimano, Alfonso

    Titles

    Investigator, BC Children's Hospital 
    Clinical Professor, Department of Pediatrics, Division of Neonatology, UBC
    Medical Director, BC RSV Immunoprophylaxis Program

    Degrees / Designations
    MD, FRCPC
    Primary Area of Research
    Healthy Starts
    Secondary Area(s) of Research
    Phone
    604-875-2135
    Fax
    Lab Phone
    Assistant
    Lisa-Marie Candeias
    Assistant Phone
    604-875-2000 x7349
    Mailing Address

    BC Children's Hospital
    4500 Oak Street
    Room 1R46
    Vancouver, BC V6H 3V4

    Affiliate Websites
    Research Areas
    • Respiratory Syncytial Virus
    • Immunoprophylaxis
    • Palivizumab
    Summary

    Respiratory Syncytial Virus (RSV) infects almost all children by two years of age. While most children will have only mild symptoms, infants with underlying cardiac or pulmonary disease and extremely premature infants are at highest risk for hospitalizations resulting from RSV infection. Palivizumab, a monoclonal antibody against RSV has demonstrated a decrease in the likelihood of hospital admission due to RSV bronchiolitis. Currently, palivizumab is only offered to infants at highest risk via, the BC RSV Immunoprophylaxis Program. My research interest focuses on achieving maximal RSV prevention through both health education, and evidence‐based, cost effective use of RSV Immunoprophylaxis.

    Current Projects

    In BC, caregivers will apply for Palivizumab dosing for their patients. The BC RSV Immunoprophylaxis Program approves applications for Palivizumab dosing either automatically, because they meet pre‐determined criteria, or their application is adjudicated by a 3 panel committee. We are currently undergoing a review of the panel of 3 adjudication process for the RSV Immunoprophylaxis program to determine if it is effective in determining those at greatest risk for RSV.

    Prior findings from our group has identified that 3 or 4 doses of Palivizumab is as effective as 5 doses in preventing RSV in the highest risk infants. We are continuing to study and understand, the role that natural immunity plays in the protection against RSV, the pharmacokinetics of Palivizumab dosing during the RSV season, the phenomemon that we see of term and later preterm infants with no pre‐existing risk factors being admitted to hospital.

    We have determined that the risk of hospital admission is not higher in applicants for immunoprophylaxis who did not meet criteria than in those who met criteria and received immunoprophylaxis. We are continuing to explore the risk‐costeffectiveness of prophylaxis threshholds in order to better inform our Program. For example, in collaboration with Perinatal Services BC and we are looking at the thresholds by gestational age at birth, and with cardiology in congenital heart disease.

    Selected Publications

    Lavoie PM, Solimano A, Taylor R, Kwan E, Claydon J, Turvey SE, Marr N. Outcomes of Respiratory Syncytial Virus Immunoprophylaxis in Infants Using an Abbreviated Dosing Regimen of Palivizumab. JAMA Pediatr. 2015 Dec 28:1‐2.

    Poets CF, Roberts RS, Schmidt B, Whyte RK, Asztalos EV, Bader D, Bairam A, Moddemann D, Peliowski A, Rabi Y, Solimano A, Nelson H; Canadian Oxygen Trial Investigators. Association Between Intermittent Hypoxemia or Bradycardia and Late Death or Disability in Extremely Preterm Infants. JAMA. 2015 Aug 11;314(6):595‐60.

    Schmidt B, Roberts RS, Whyte RK, Asztalos EV, Poets C, Rabi Y, Solimano A, Nelson H; Canadian Oxygen Trial Group. Impact of study oximeter masking algorithm on titration of oxygen therapy in the Canadian oxygen trial. J Pediatr. 2014 Oct;165(4):666‐671.

    Marr N, Wang TI, Kam SH, Hu YS, Sharma AA, Lam A, Markowski J, Solimano A, Lavoie PM, Turvey SE. Attenuation of Respiratory Syncytial Virus‐Induced and RIG‐I‐Dependent Type I IFN Responses in Human Neonates and Very Young Children. J Immunol. 2014 Feb 1;192(3):948‐57.

    Konduri GG, Sokol GM, Van Meurs KP, Singer J, Ambalavanan N, Lee T, Solimano A. Impact of early surfactant and inhaled nitric oxide therapies on outcomes in term/late preterm neonates with moderate hypoxic respiratory failure. J Perinatol. 2013 Dec;33(12):944‐9.

    Schmidt B, Whyte RK, Asztalos EV, Moddemann D, Poets C, Rabi Y, Solimano A, Roberts RS; Canadian Oxygen Trial (COT) Group. Effects of targeting higher vs lower arterial oxygen saturations on death or disability in extremely preterm infants: a randomized clinical trial. JAMA. 2013 May 22;309(20):2111‐20.

    Cheong JL, Coleman L, Hunt RW, Lee KJ, Doyle LW, Inder TE, Jacobs SE; Infant Cooling Evaluation Collaboration. Prognostic utility of magnetic resonance imaging in neonatal hypoxic‐ischemic encephalopathy: substudy of a randomized trial. Arch Pediatr Adolesc Med. 2012 Jul 1;166(7):634‐40.

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