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Treatment of respiratory syncytial virus with palivizumab: a systematic review

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Abstract

Background

Palivizumab has proven efficacy for prophylaxis of respiratory syncytial virus (RSV) in infants with prematurity or congenital heart disease. Despite a paucity of data, palivizumab is sometimes used to prevent progression when high-risk patients present with upper respiratory tract infection (URTI) due to RSV, or as therapy when any patients present with severe lower respiratory tract infection (LRTI) caused by RSV.

Methods

A systematic review of the literatures on the use of palivizumab as therapy for RSV was conducted. The primary outcomes were progression from URTI to LRTI and survival rates. Secondary outcomes were adverse events due to palivizumab, serum palivizumab level, and RSV concentration in respiratory secretions.

Results

The search yielded 1 case report, 4 case series, and 2 randomized controlled trials (RCTs) with a total of 136 adults and children. The RCTs were not powered to look at clinical outcomes. By combining all reported clinical outcomes, 3 (12%) of 25 patients with URTI who were given palivizumab died of RSV and 5 of 88 patients with LRTI at the time of treatment died of RSV (6%). Palivizumab levels appeared to be adequate for at least 3 weeks of intravenous injection at 15 mg/kg. The therapy resulted in decreased RSV concentrations in tracheal secretions.

Conclusion

Larger RCTs will be required before palivizumab can be recommended as therapy for RSV in any clinical setting.

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Authors and Affiliations

  1. Department of Pediatrics and Stollery Children’s Hospital, University of Alberta, Edmonton, Canada

    Jia Hu & Joan L. Robinson

  2. Room 8213, Aberhart Centre One, 11402 University Avenue, Edmonton, AB, Canada, T6G 2J3

    Joan L. Robinson

Authors
  1. Jia Hu
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  2. Joan L. Robinson
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Correspondence to Joan L. Robinson.

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Hu, J., Robinson, J.L. Treatment of respiratory syncytial virus with palivizumab: a systematic review. World J Pediatr 6, 296–300 (2010). https://doi.org/10.1007/s12519-010-0230-z

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  • DOI: https://doi.org/10.1007/s12519-010-0230-z

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