title: Rationale for full-season dosing for passive antibody prophylaxis of respiratory syncytial virus.
abstract: Palivizumab monthly injections throughout the RSV season prevent severe respiratory syncytial virus (RSV) disease in preterm infants ≤ 35 wGA. However, some RSV guidelines currently recommend stopping palivizumab after 3 months of age in the midst of the RSV season. This article evaluates the need for full-season dosing by reviewing the pharmacokinetic properties of palivizumab and RSV hospitalization (RSVH) risk as a function of chronologic age. Precise human palivizumab protective levels are not established. Clinical trials show significant interpatient variability in palivizumab serum trough concentrations. Partial season dosing is associated with increased risk of RSVH. For late-preterm infants, data suggest that the risk of RSVH remains elevated through at least 6 months of age. Monthly, full-season palivizumab dosing provides the only empirically proven protection from RSVH. In conclusion, late-preterm infants are at significant risk for RSVH through at least 6 months of age and would benefit from dosing throughout the RSV season.
authors: MedImmune; Gaithersburg, MD USA.
authors: Doris
authors: D
authors: Makari
authors: Texas Children's Hospital; Baylor College of Medicine; Houston, TX USA.
authors: Paul A
authors: PA
authors: Checchia
authors: Departments of Pediatrics; Microbiology, Immunology and Molecular Biology; University of Tennessee School of Medicine; Memphis, TN USA; Children's Foundation Research Institute; Le Bonheur Children's Hospital; Memphis, TN USA.
authors: John
authors: J
authors: Devincenzo
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000914:Antibodies, Viral / Q000008:administration & dosage*; D002675:Child, Preschool; D006801:Humans; D007116:Immunization, Passive / Q000379:methods*; D007223:Infant; D000069455:Palivizumab; D018357:Respiratory Syncytial Virus Infections / Q000453:epidemiology / Q000517:prevention & control*; D018113:Respiratory Syncytial Virus, Human / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000914:Antibodies, Viral; D000069455:Palivizumab
keywords: guidelines; monthly dosing; palivizumab; preterm infants; respiratory syncytial virus