title: Safety and pharmacokinetics of extended use of palivizumab in Saudi Arabian infants and children.
abstract: BACKGROUND
  The peak season of respiratory syncytial virus (RSV) infections in warmer climates may extend beyond the typical five-month RSV season of temperate regions. Additional monthly doses of palivizumab may be necessary in warmer regions to protect children at high risk for serious infection by the RSV.
  
  
  METHODS
  In a Phase II, single-arm, single-center, non-comparative, open-label, prospective study conducted in Saudi Arabia, children at high risk for RSV infection received up to seven monthly injections of palivizumab (15 mg/kg) during the 2000-2001 RSV season. Key enrollment criteria were no previous exposure to palivizumab and gestational age ≤35 weeks, ≤6 months of age at enrollment, or chronic lung disease and ≤24 months of age at enrollment. We wished to assess the safety, immunogenicity, and pharmacokinetics of palivizumab as an extended seven-dose regimen.
  
  
  RESULTS
  Of 18 enrolled patients, 17 patients received seven palivizumab injections. Seven adverse events (AEs) occurred in five patients. Bronchiolitis was the most commonly reported AE. Six serious AEs occurred in four patients. No AEs were considered related to palivizumab. Trough levels of palivizumab in serum were >40 μg/mL in most patients after the first injection and in 16/18 and 14/17 patients after the fourth and sixth injections, respectively. Except for one patient at one visit, the anti-palivizumab titer was <1:10 at all visits.
  
  
  CONCLUSIONS
  These data suggest that an extended palivizumab regimen of up to seven monthly doses during the RSV season exhibited an acceptable safety profile in children at high risk for RSV infection in Saudi Arabia.
authors.affiliation: Neonatology Section, Department of Pediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia;
authors.forename: Saleh
authors.initials: S
authors.lastname: Al-Alaiyan
authors.affiliation: GI Immunology Medical Affairs, Global Pharmaceutical and Research Division, AbbVie Inc., North Chicago, IL, USA;
authors.forename: Paul
authors.initials: P
authors.lastname: Pollack
authors.affiliation: Virology Global Project Team, Global Pharmaceutical Research and Development, AbbVie Inc., North Chicago, IL, USA.
authors.forename: Gerard F
authors.initials: GF
authors.lastname: Notario
keywords: Saudi Arabia; infants; open-label; palivizumab; pediatrics; pharmacokinetics; respiratory syncytial virus; safety