Palivizumab in congenital heart disease: should international guidelines be revised?
Palivizumab has reduced the incidence of respiratory syncytial virus hospitalization in infants and children with congenital heart disease by 45%. Although the mortality rate of children with congenital heart disease hospitalized with respiratory syncytial virus infection has declined from 37% to approximately 3% over the past 3 decades, palivizumab has not been shown to improve mortality. There has been considerable controversy over the cost-effectiveness of administering palivizumab according to international guidelines, including children with congenital heart disease. In particular, the number of children that need to be treated with palivizumab to prevent one respiratory syncytial virus hospitalization increases dramatically in children > 12 months of age. As a result, the authors recommend that countries re-examine their recommendations for providing palivizumab up to age 24 months in children with congenital heart disease.
Geskey
Joseph M
JM
Thomas
Neal J
NJ
Brummel
Gretchen L
GL
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D006330:Heart Defects, Congenital / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007391:International Cooperation; D000069455:Palivizumab; D017410:Practice Guidelines as Topic; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy* / Q000821:virology
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab