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Palivizumab


Presentation

  • The present report describes three infants receiving palivizumab prophylaxis who presented with apnea associated with respiratory syncytial virus (RSV) infection. All three were found to be RSV positive but had mild bronchiolitis courses.[ncbi.nlm.nih.gov]
  • RESULTS: Among the 198 studied infants, 117 (59.1%) presented acute respiratory tract infections, with a total of 175 episodes.[ncbi.nlm.nih.gov]
  • The present expression system was useful for investigating the mechanisms of RSV cell fusion. Copyright 2016 Elsevier B.V. All rights reserved.[ncbi.nlm.nih.gov]
  • We present facts and conclude that introduction of palivizumab into clinical practice for the most vulnerable patient category was done without confirmation of efficacy, without pharmacoeconomics evaluations, without any precautionary measures in a country[ncbi.nlm.nih.gov]
  • We present 2 children with acute lymphocytic leukemia (ALL) and persistent RSV infection while receiving chemotherapy. Patient A is a 4-year-old male with Down syndrome, ALL, and persistent RSV infection for at least 3 months.[ncbi.nlm.nih.gov]
Intravenous Administration
  • Intravenous Administration NOTE: Palivizumab is not approved by the FDA for intravenous administration. NOTE: In early clinical trials, lyophilized palivizumab was administered via the intravenous route.[pdr.net]
Hodgkin's Disease
  • A case is reported of a 56-y-old woman with a second relapse of Hodgkin's disease who early developed after autologous stem cell transplantation (ASCT) a severe RSV-related interstitial pneumonia successfully treated with 1-d intravenous palivizumab 8[ncbi.nlm.nih.gov]
Noncompliance
  • The main reasons for noncompliance were non-approval by the medical insurance (53 %), parents' unavailability (31 %), and infant sickness (11 %).[ncbi.nlm.nih.gov]
Poor Feeding
  • Many treatments have been tried but few, if any, show any benefit, and we are left with supportive, yet effective treatments: oxygen, management of poor feeding, and good nursing care.[fn.bmj.com]
Arthritis
  • Among the children exposed to palivizumab, one child in Denmark developed inflammatory bowel disease; in Sweden, children developed juvenile arthritis (one child), diabetes mellitus (two children), celiac disease (four children), and inflammatory bowel[ncbi.nlm.nih.gov]
  • Cardiology Emergency Medicine Gastroenterology General Medicine HIV/AIDS Hospital Medicine Infectious Diseases Neurology Oncology and Hematology Pediatrics and Adolescent Medicine Psychiatry Women’s Health Topics: Aging / Geriatrics Allergy / Asthma Arthritis[jwatch.org]
Withdrawn
  • […] hepatitis-B surface antigen, poliovirus (inactivated) (type 1 (Mahoney strain), type 2 (MEF-1 strain), type 3 (Saukett strain)), Hepatitis B, Tetanus, Immunization, Whooping Cough, Poliomyelitis, Diphtheria Date of authorisation: 23/10/2000, Revision: 13, Withdrawn[ema.europa.eu]
  • Half life 18-20 days (in adults) Clearance Not Available Toxicity Not Available Affected organisms Not Available Pathways Not Available Pharmacogenomic Effects/ADRs Not Available Drug Interactions All Drugs Approved Vet approved Nutraceutical Illicit Withdrawn[drugbank.ca]

Workup

Bordetella Pertussis
  • Human medicine European public assessment report (EPAR): Infanrix Penta Diphtheria toxoid, tetanus toxoid, Bordetella pertussis antigens (pertussis toxoid, filamentous haemagglutinin, pertactin), hepatitis-B surface antigen, poliovirus (inactivated) ([ema.europa.eu]

Treatment

  • Patients born between 2007 and 2013, diagnosed with chILD and on corticosteroid treatment were identified through the French online database for pediatric interstitial lung disease (Respirare( ) ).[ncbi.nlm.nih.gov]
  • IV palivizumab may be a treatment option for persistent RSV infection among immunocompromised patients.[ncbi.nlm.nih.gov]
  • B-cells suppression with CMV antigenaemia were then observed and required treatment with ganciclovir and liposomal amfotericine B.[ncbi.nlm.nih.gov]
  • What is New: • Compared with other infants receiving palivizumab prophylaxis, patients with Down syndrome significantly more often had congenital heart disease, siblings in kindergarten or school, treatment with oxygen at home, immunodeficiency, and neuromuscular[ncbi.nlm.nih.gov]
  • BACKGROUND: Treatment with biologic pharmaceuticals may be associated with an increased risk of immune-mediated disease.[ncbi.nlm.nih.gov]

Prognosis

  • Of course, we recognize that no robust evaluation of the impact of palivizumab treatment on outcome can be made here, because palivizumab was sometimes given to patients with classic indicators of a poorer prognosis (i.e., infection was diagnosed soon[doi.org]

Etiology

  • Data were collected for the etiology and severity of chILD, risk factors and preventive measures for bronchiolitis, palivizumab immunoprophylaxis, and hospitalizations for bronchiolitis and RSV-bronchiolitis.[ncbi.nlm.nih.gov]
  • Of the 198 children, 48 (24.4%) were hospitalized: 30 (15.2%) for non-infectious etiology and 18 (9.1%) for respiratory causes. Among these 18 children, one case of respiratory syncytial virus was identified.[ncbi.nlm.nih.gov]
  • Viral respiratory diseases in children: classification, etiology, epidemiology, and risk factors. J Pediatr. 1994; 124(Suppl):S13-6. 24. Hemming VG, moderator. Questions and answers.[drugs.com]
  • Incidence of RSV-related Hospitalization During the first 6 months after first palivizumab immunization, 22 subjects were hospitalized due to respiratory tract infections irrespective of the etiology and only 2 had hospitalization due to RSV infection[journals.plos.org]

Epidemiology

  • Publication type, MeSH terms, Substances Publication type Case Reports MeSH terms Antibodies, Monoclonal/administration & dosage* Antibodies, Monoclonal, Humanized Antiviral Agents/administration & dosage* Cross Infection/drug therapy Cross Infection/epidemiology[ncbi.nlm.nih.gov]
  • […] an epidemiological study from 2004 to 2012; recurrent wheezing rates associated to RSV infection from SPRING study were adjusted by the evidence on the palivizumab effect from clinical trials.[ncbi.nlm.nih.gov]
  • RSV is the primary cause of lower respiratory tract infection in children aged KEYWORDS: Adherence; compliance; epidemiology; monoclonal antibody; palivizumab; prophylaxis; respiratory syncytial virus; respiratory tract infection[ncbi.nlm.nih.gov]
  • Abstract Following the most recent modification by the American Academy of Pediatrics, based on American studies on RSV epidemiology, the Italian Drug Agency (AIFA) decided to limit the total financial coverage of the palivizumab prescription by the National[ncbi.nlm.nih.gov]
  • BACKGROUND: Due to different social and epidemiological factors, the eligibility criteria to receive palivizumab prophylaxis may be different between countries, especially in "otherwise healthy" late preterm infants.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Respiratory syncytial virus puzzle: clinical features, pathophysiology, treatment, and prevention. J Pediatr. 1992; 121:503-10. 17. Groothuis JR, Simoes EAF, Hemming VG et al et al.[drugs.com]

Prevention

  • CONCLUSIONS: Using a test-negative case-control design with RSV molecular detection, palivizumab is shown to prevent RSV hospitalizations and intensive care unit admissions in high-risk infants.[ncbi.nlm.nih.gov]
  • The American Academy of Pediatrics does not recommend palivizumab to prevent health care-associated RSV (HA-RSV).[ncbi.nlm.nih.gov]
  • Also, if palivizumab is found to be ineffective in preventing apnea, clinical management of these patients could be altered.[ncbi.nlm.nih.gov]
  • Currently, there are 2 options for immunoprophylaxis for preventing respiratory syncytial virus (RSV) infection in high-risk infants.[pediatrics.aappublications.org]
  • Consensus against the use of palivizumab as prevention of RSV infection was also achieved in almost all the recurrent wheezing/asthma attacks situations.[ncbi.nlm.nih.gov]

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