Palivizumab
Encyclopedia
Palivizumab is a monoclonal antibody produced by recombinant DNA technology. It is used in the prevention of respiratory syncytial virus (RSV) infections. It is recommended for infants that are high-risk because of prematurity or other medical problems such as congenital heart disease.
Palivizumab is a humanized monoclonal antibody (IgG) directed against an epitope in the A antigenic site of the F protein of RSV. In two Phase III clinical trials in the pediatric population, palivizumab reduced the risk of hospitalization due to RSV infection by 55% and 45%. Palivizumab is dosed once a month via intramuscular (IM) injection, to be administered throughout the duration of the RSV season.
Palivizumab targets the fusion protein of RSV, inhibiting its entry into the cell and thereby preventing infection.
(AAP) has published recommendations for the use of palivizumab Updated AAP recommendations were published in 2009. Palivizumab (brand name Synagis manufactured by MedImmune) is used only for prevention, not for treatment, and once initiated for a given RSV season (usually November–March), it should be continued for the full duration of that season.
Reasons to consider palivizumab prophylaxis include:
Other conditions where prophylaxis might be considered but inadequate data is available:
Of note, a course of palivizumab is quite expensive, and the above recommendations were written based on estimates of its overall cost-effectiveness for preventing severe RSV disease. However, the issues of cost versus benefit remain an area of ongoing research and discussion.
Palivizumab is a humanized monoclonal antibody (IgG) directed against an epitope in the A antigenic site of the F protein of RSV. In two Phase III clinical trials in the pediatric population, palivizumab reduced the risk of hospitalization due to RSV infection by 55% and 45%. Palivizumab is dosed once a month via intramuscular (IM) injection, to be administered throughout the duration of the RSV season.
Palivizumab targets the fusion protein of RSV, inhibiting its entry into the cell and thereby preventing infection.
Recommendations for use
The American Academy of PediatricsAmerican Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...
(AAP) has published recommendations for the use of palivizumab Updated AAP recommendations were published in 2009. Palivizumab (brand name Synagis manufactured by MedImmune) is used only for prevention, not for treatment, and once initiated for a given RSV season (usually November–March), it should be continued for the full duration of that season.
Reasons to consider palivizumab prophylaxis include:
- PrematurityPremature birthIn humans preterm birth refers to the birth of a baby of less than 37 weeks gestational age. The cause for preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging...
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- ≤ 28 weeks gestation and < 12 months of age at the start of RSV season
- 29-32 weeks gestation and < 6 months of age at the start of RSV season
- 32-35 weeks gestation and < 3 months of age at the start of RSV season, if there is a risk factor (child care attendance or sibling younger than 5 years old)
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- Chronic lung disease of prematurityBronchopulmonary dysplasiaBronchopulmonary dysplasia is a chronic lung disorder that is most common among children who were born prematurely, with low birthweights and who received prolonged mechanical ventilation to treat respiratory distress syndrome...
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- Chronic lung disease still requiring oxygen/medication, for the first and second RSV seasons
- Chronic lung disease that required oxygen/medication within the 6 months preceding RSV season, for the first RSV season
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- Congenital heart disease
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- Cyanotic heart disease, for the first 24 months of life
- Moderate to severe pulmonary hypertension, for the first 24 months of life
- Congestive heart failure requiring medication, for the first 24 months of life
- Children who have undergone open heart surgery during RSV season, for one additional dose after cardiopulmonary bypass (only if they still meet one of the other criteria)
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Other conditions where prophylaxis might be considered but inadequate data is available:
- Immunocompromise
- Cystic fibrosisCystic fibrosisCystic fibrosis is a recessive genetic disease affecting most critically the lungs, and also the pancreas, liver, and intestine...
Of note, a course of palivizumab is quite expensive, and the above recommendations were written based on estimates of its overall cost-effectiveness for preventing severe RSV disease. However, the issues of cost versus benefit remain an area of ongoing research and discussion.