Palivizumab Prophylaxis for Respiratory Syncytial Virus: Examining the Evidence Around Value

Olchanski, Natalia; Hansen, Ryan N.; Pope, Elle; D’Cruz, Brittany; Fergie, Jaime; Goldstein, Mitchell; Krilov, Leonard R.; McLaurin, Kimmie; Nabrit-Stephens, Barbara; Oster, Gérald; Schaecher, Kenneth L.; Shaya, Fadia T.; Neumann, Peter J.; Sullivan, Sean D.

doi:10.1093/ofid/ofy031

Cited by 62 publications

(57 citation statements)

References 29 publications

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“…Currently, RSV vaccines under development are in phase III clinical trials, constituting a step in the right direction . In infants at high‐risk (preterm or having chronic illness), RSV neutralizing monoclonal antibodies, including the FDA‐approved palivizumab, are effective for prophylaxis but remain very expensive in developing countries . The emergence of RSV variants that are resistant to palivizumab is a concern that highlights the need for more therapeutic options .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Soudani

Caniza

Assaf-Casals

et al. 2019

Journal of Medical Virology

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Background: Patients with pediatric cancer have a higher risk of morbidity and mortality because of respiratory viral infections than other patient populations.Objectives: To investigate the causative viruses of respiratory infections and their burden among patients with pediatric cancer in Lebanon.Study design: Nasopharyngeal swabs along with clinical and demographic data were collected from patients with pediatric cancer presenting febrile episodes with upper respiratory tract symptoms. Total nucleic acid was extracted from specimens followed by the real-time PCR analysis targeting 14 respiratory viruses to estimate the frequency of infections. Results:We obtained 89 nasopharyngeal swabs from patients with pediatric cancer (mean age, 5.8 ± 4.2 years). Real-time PCR confirmed viral infection in 77 swabs (86.5%). Among these, 151 respiratory viruses were detected. Several viruses cocirculated within the same period; respiratory syncytial virus (RSV) being the most common (45.45%), followed by parainfluenza virus (PIV; 26%), influenza type B (26%), human metapneumovirus (24.6%), and human coronavirus (HCoV; 24.6%). Coinfections were detected in 55% of the subjects, and most of them involved RSV with one or more other viruses. A strong correlation was found between PIV, Flu (influenza of any type), RSV, and HCoV with the incidence of coinfections. RSV was associated with lower respiratory tract infections, nasal congestion, bronchitis, and bacteremia. HCoV was associated with bronchiolitis; rhinovirus was associated with hospital admission. Conclusion: Patients with pediatric cancer have a high burden of respiratory viral infections and a high incidence of coinfections. Molecular diagnostics can improve management of febrile episodes and reduce antibiotic use. K E Y W O R D S coinfection, patients with pediatric cancer, prevalence, real-time PCR, respiratory tract infections, virus infections J Med Virol. 2019;91:1191-1201. wileyonlinelibrary.com/journal/jmv

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Section: Discussionmentioning

confidence: 99%

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Soudani

Caniza

Assaf-Casals

et al. 2019

Journal of Medical Virology

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“…In addition, some studies have found a lower risk for severe RSV‐associated infection than those reported in palivizumab efficacy studies, particularly in otherwise heathy preterm infants, leading to changes in the recommendations for palivizumab administration in the United States . However, questions still remain regarding the optimal approach for RSV prophylaxis with palivizumab, and the need for additional epidemiological data regarding the incidence of RSV hospitalizations has been identified . The incidence of ARI‐ and RSV‐associated hospitalizations varies in different countries .…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] However, questions still remain regarding the optimal approach for RSV prophylaxis with palivizumab, and the need for additional epidemiological data regarding the incidence of RSV hospitalizations has been identified. 11,12 The incidence of ARI-and RSV-associated hospitalizations varies in different countries. [13][14][15][16] This could be the result of diverse factors, including social conditions, environmental factors, or healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

Respiratory syncytial virus acute respiratory infection‐associated hospitalizations in preterm Mexican infants: A cohort study

Benítez‐Guerra

Piña‐Flores

Zamora‐López

et al. 2020

Influenza Resp Viruses

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Background Respiratory syncytial virus (RSV) is the leading cause of severe acute respiratory infections (ARI) in preterm infants. The incidence of RSV‐associated hospitalizations has not been defined in Mexico. Objectives To determine the incidence of ARI‐ and RSV‐associated hospitalizations in preterm infants during the first year of life. Methods Prospective cohort study of 294 preterm infants followed up through monthly telephone calls and routine outpatient visits. Hospitalized children were identified through daily visits to pediatric wards of participating hospitals and through telephone calls. Respiratory samples were tested for RSV by RT‐PCR. Results Mean gestational age of participating infants was 33 weeks. Ninety‐six infants were diagnosed with bronchopulmonary dysplasia (BPD) and 17 with congenital heart disease (CHD); 11 had both conditions. There were 71 hospitalization episodes in 53 infants. Respiratory samples for RSV detection were available in 44 hospitalization episodes, and the result was positive in 16 (36.3%). At least one hospitalization for ARI was recorded in 33 of 96 participants with BPD, in seven of 17 with CHD, and 18 of 192 infants without these diagnoses. Five (71.4%) of CHD infants who required admission also had BPD. RSV‐confirmed hospitalization rates were 9.4%, 5.9%, and 2.6% for infants with BPD, CHD, and otherwise healthy preterm infants, respectively. Attributable RSV admission frequencies were estimated to be 13.6%, 16.5%, and 4.1%, respectively. Conclusions Mexican preterm infants, particularly those with BPD, have high rates of ARI‐ and RSVassociated hospitalizations. Specific interventions to reduce the incidence of severe infections in this highrisk group are required.

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“…Neutralizing antibodies against nCoV 19 surface antigens prevent virus entry of which, S protein considered as a good candidate. These monoclonal neutralizing antibodies provide a passive immunity in the time of exposure like palvizumab as a putative example that has been applied for prevention of RSV infection (92). Anti-inflammatory antibodies like anti IL6 receptor (Tocilizumab) and anti ITGA4 (Natalizumab) may inhibit inflammation and cellular extravasion (101, 102).…”

Section: Monoclonal Antibodies and Recombinant Proteinsmentioning

confidence: 99%

The Molecular Story of COVID-19; NAD<sup>+</sup><sup> </sup>Depletion Addresses All Questions in this Infection

Kouhpayeh¹,

Shariati²,

Boshtam³

et al. 2020

Preprint

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The emerging new Coronaviridae member, nCoV 19, outbreak announced a pandemic by WHO with an increased morbidity and mortality rate worldwide. nCoV 19 known as the third highly pathogen coronavirus in the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), the nCoV 19. The renin-angiotensin (RAS) signaling pathway, oxidative stress and cell death, cytokines storm and endothelial dysfunction are four major pathways involved in the pathogenesis of nCoV 19. Acute respiratory distress syndrome (ARDS) generally develops with a massive oxidative/nitrosative stress following virus entry and RAS activation. The DNA damage subsequent to oxidative burst activates poly-ADP ribose polymerase-1 (PARP-1), viral macrodomain (NSP3) poly (ADP-ribose) glycohydrolase (PARG) and transient receptor potential channel, melastatin 2 (TRPM2) in a sequential manner ultimately leading to apoptosis and necrosis due to NAD and ATP depletion. Regarding the molecular mechanisms involved in nCoV 19 pathogenesis, angiotensin II receptor blockers and/or PARP, PARG and TRPM2 blockers could be engaged as therapeutic candidates for inhibition of RAS and quenching oxidative stress, respectively. In this review, the molecular aspects of nCoV 19 pathogenesis would be studied precisely and possible therapeutic targets would be proposed. It is recommended to evaluate the proposed drugs and supplements via registered clinical trials along with conventional guideline-based multi-drug regimen.

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Palivizumab Prophylaxis for Respiratory Syncytial Virus: Examining the Evidence Around Value

Cited by 62 publications

References 29 publications

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Prevalence and characteristics of acute respiratory virus infections in pediatric cancer patients

Respiratory syncytial virus acute respiratory infection‐associated hospitalizations in preterm Mexican infants: A cohort study

The Molecular Story of COVID-19; NAD<sup>+</sup><sup> </sup>Depletion Addresses All Questions in this Infection

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