Palivizumab
Palivizumab
Palivizumab is an intramuscularly administered humanised monoclonal antibody for prophylaxis of serious respiratory syncytial virus (RSV) infection in high risk infants. It is effective and well tolerated, and is more convenient to administer than the alternative prophylactic agent, RSV-immune globulin intravenous (human) [RSV-IGIV]. The long term effects and cost effectiveness of palivizumab are not known, and comparative data for palivizumab versus RSV-IGIV are lacking. However, palivizumab is preferred over RSV-IGIV in most at-risk infants for the prophylaxis of serious RSV infection.
Respiratory syncytial virus (RSV) infects >95% of children by the age of 2 years and reinfects more than 50% of children each year. It accounts for the majority of cases of bronchiolitis and pneumonia in infants and young children; hospitalisation for severe RSV infection is required in 0.5 to 2% of all infected children. Risk factors for severe RSV infection include prematurity (gestational age ≤35 weeks at birth), chronic lung disease (bronchopulmonary dysplasia), congenital heart disease and bodyweight <5kg. Infection is most prevalent during the RSV season (winter and early spring).
Prophylaxis is indicated for infants and children at high risk for serious RSV infection according to guidelines published by the American Academy of Pediatrics (AAP; see table 1). Two neutralising antibody preparations, palivizumab and RSV-immune globulin intravenous (human) [RSV-IGIV], have been developed for prophylaxis of RSV infection and are compared in the Differential features table. Neither is effective in the treatment of existing RSV infection. Importantly, administration of palivizumab or RSV-IGIV does not increase the severity of RSV infection or pulmonary pathology after subsequent challenge with RSV; these effects were observed in infants who received a formalin-inactivated RSV vaccine in the early 1960s.
Palivizumab is an intramuscularly administered humanised monoclonal antibody for prophylaxis of serious respiratory syncytial virus (RSV) infection in high risk infants. It is effective and well tolerated, and is more convenient to administer than the alternative prophylactic agent, RSV-immune globulin intravenous (human) [RSV-IGIV]. The long term effects and cost effectiveness of palivizumab are not known, and comparative data for palivizumab versus RSV-IGIV are lacking. However, palivizumab is preferred over RSV-IGIV in most at-risk infants for the prophylaxis of serious RSV infection.
Respiratory syncytial virus (RSV) infects >95% of children by the age of 2 years and reinfects more than 50% of children each year. It accounts for the majority of cases of bronchiolitis and pneumonia in infants and young children; hospitalisation for severe RSV infection is required in 0.5 to 2% of all infected children. Risk factors for severe RSV infection include prematurity (gestational age ≤35 weeks at birth), chronic lung disease (bronchopulmonary dysplasia), congenital heart disease and bodyweight <5kg. Infection is most prevalent during the RSV season (winter and early spring).
Prophylaxis is indicated for infants and children at high risk for serious RSV infection according to guidelines published by the American Academy of Pediatrics (AAP; see table 1). Two neutralising antibody preparations, palivizumab and RSV-immune globulin intravenous (human) [RSV-IGIV], have been developed for prophylaxis of RSV infection and are compared in the Differential features table. Neither is effective in the treatment of existing RSV infection. Importantly, administration of palivizumab or RSV-IGIV does not increase the severity of RSV infection or pulmonary pathology after subsequent challenge with RSV; these effects were observed in infants who received a formalin-inactivated RSV vaccine in the early 1960s.
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