Palivizumab

Palivizumab (brand name Synagis which is manufactured by MedImmune) 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 (brand name Synagis which is manufactured by MedImmune) 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. Palivizumab was approved for medical use in 1998. Palivizumab is used to reduce the risk of respiratory syncytial virus in children at increased risk of severe disease. Since the beginning of the drug's release, the American Academy of Pediatricshas updated its guidance for the use of palivizumab 4 times asadditional data became available to provide a better understanding ofinfants and young children at greatest risk of hospitalization attributableto RSV infection. The updated recommendations in this policystatement reflect new information regarding the seasonality of RSVcirculation, palivizumab pharmacokinetics, the changing incidence ofbronchiolitis hospitalizations, the effect of gestational age and other riskfactors on RSV hospitalization rates, the mortality of children hospitalizedwith RSV infection, the effect of prophylaxis on wheezing, andpalivizumab-resistant RSV isolates. This policy statement updates andreplaces the recommendations found in the 2012 Red Book. Pediatrics2014;134:415–420 Infants younger than one year with bronchopulmonary dysplasia (i.e. who were born at <32 weeks gestation and required supplemental oxygen for the first 28 days after birth) and infants younger than two years with bronchopulmonary dysplasia who required medical therapy (e.g. supplemental oxygen, glucocorticoids, diuretics) within six months of the anticipated RSV season are recommended to use palivizumab as prophylaxis. Also, infants younger than one year who were born at <29 weeks (i.e. ≤28 weeks, 6 days) of gestation are recommended to use palivizumab. Other potential target groups for palivizumab prophylaxis include: