Palivizumab Prophylaxis for Healthy Preterm Infants: More Data Supporting American Academy of Pediatrics Guidelines

Byington, Carrie L.

doi:10.1542/peds.2016-1494

Cited by 6 publications

(6 citation statements)

References 11 publications

(14 reference statements)

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“…Algunos estudios han sugerido que la infección por VRS podría estar asociado con el asma atópica y sibilancias recurrentes (20) . Para aquellos niños que tienen protección de anticuerpos contra el VSR adquiridos a través de la administración de Palivizumab y que también tienen la bronquiolitis, la causa puede ser un virus distinto del RSV (3) . Las hospitalizaciones por VSR y los patrones de actividad regionales tienden a reflejar entre sí, aunque ~ 10% de las hospitalizaciones ocurren fuera de temporada, sistemáticamente han iniciado antes y han durado más tiempo (15) .…”

Section: Generalidades Y Epidemiología De Vsrunclassified

“…El Palivizumab fue aprobado en 1998 por la Food and Drug Administration (FDA) para el uso profiláctico en RNPT con o sin broncodisplasia pulmonar (DBP), tras los resultados aportados por el ensayo clínico IMpact-VSR (1) , el objetivo era disminuir la carga de enfermedad grave por VSR, reducción de las tasas y días totales de hospitalización, días de oxigenoterapia y disminución en las admisiones a UCIN por infecciones asociadas a este (2,3) . Debido a las diferencias existentes entre las recomendaciones elaboradas por distintos organismos para la administración de Palivizumab como profilaxis de las infecciones por VSR en prematuros para reducir la mortalidad, la elaboración de esta revisión es para recoger información actualizada de la literatura científica y con ello aclarar las discrepancias detectadas entre las diferentes recomendaciones (4)(5)(6)(7)(8)(9)(10) .…”

Section: Introductionunclassified

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Uso de Palivizumab en Recién Nacidos Prematuros

Martínez

Márquez²

2019

Act Ped Hond

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El Palivizumab es una terapia biológica perteneciente a la familia de los anticuerpos monoclonales IgG, indicado para la prevención de enfermedad respiratoria inferior grave causada por el Virus Sincitial Respiratorio (VSR) en neonatos prematuros con factores de riesgo. Los recién nacidos pretérminos (RNPT) se consideran los más susceptibles a dichas enfermedades en comparación con los recién nacidos a términos (RNT) sanos, lo que se traduce en mayores ingresos a Unidades De Cuidados intensivos Neonatales (UCIN), mayores costos hospitalarios y mayor morbi mortalidad. La profilaxis con Palivizumab según la última actualización de la Academia Americana de Pediatría (AAP) se puede administrar a los recién nacidos ≥ 29 semanas y 0 días de gestación que son menores de 12 meses en el inicio de la temporada del VSR o sean dados de alta durante ella. Para los recién nacidos durante la estación del VSR, se necesitarán al menos 5 dosis. Dada la controversia que existe actualmente en el uso de Palivizumab, por sus altos costos y discrepancias en las indicaciones relacionadas con la edad gestacional decidimos hacer una revisión bibliográfica del uso de Palivizumab en RNPT.

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Section: Generalidades Y Epidemiología De Vsrunclassified

Section: Introductionunclassified

Uso de Palivizumab en Recién Nacidos Prematuros

Martínez

Márquez²

2019

Act Ped Hond

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“…The guidance remains controversial with literature in support of and against the new restrictions [4][5][6][7][8]. Farber, et al studied infants born over a three-year period between 29-36 weeks gestation without chronic illness in Texas who were enrolled in managed Medicaid.…”

Section: Original Articlementioning

confidence: 99%

Impact of Adopting 2014 Guidance for Palivizumab Prophylaxis for Children Previously Considered at High Risk for Severe Respiratory Syncytial Virus Disease

Quick¹

2017

Int J Respir Pulm Med

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Objectives: This is a report of pediatric patients hospitalized with Respiratory Syncytial Virus Infection (RSV) during the season prior to, and 2 seasons following the 2014 palivizumab prophylaxis guidance release. The primary aim was to determine the effect of the 2014 guidance on children no longer considered eligible for prophylaxis. Secondary aims were to 1) Describe and compare morbidity among all children hospitalized with RSV following the 2014 guidance, 2) Assess adherence to the updated guidance, and 3) Assess associated drug cost savings. Study design:We performed a retrospective chart review of pediatric patients admitted for RSV disease at our institution during the RSV season from October 2013 -March 2016. Patients who met prior palivizumab qualifications, but were excluded according to 2014 guidance were compared pre and post adoption of 2014 palivizumab guidance. Neonatal Intensive Care Unit (NICU) records were assessed for adherence to 2014 guidance and resulting palivizumab drug cost was compared.Results: Among cases qualifying according to previous guidance, but excluded in the 2014 update, there were no significant differences seen in the rate of RSV hospitalization, admission to higher level of care, increased respiratory support requirement, or length of stay. Following the adoption of 2014 guidance, palivizumab dosing was reduced by 58%; the rate of appropriate prophylaxis among NICUs was 91%. This reduction resulted in an annual drug cost savings of $225,000. Conclusion:Adoption of updated 2014 guidance at our institutions had little impact on hospitalization with RSV disease, while allowing for better resource management.

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“…An example is the disappointing Phase 3 clinical trial assessing a Novavax RSV F protein maternal vaccine [27]. Likewise, the results from immune prophylaxis studies in high-risk patients with monoclonal antibodies to the RSV F protein (palivizumab) showed that administration is effective at reducing hospitalization but is not fully protective against disease [1,33,34,35]. Structural differences between pre- and post-fusion F protein likely have a role in RSV vaccine outcome and OAS.…”

mentioning

confidence: 99%

“…Studies have shown reduced influenza VE year-to-year and reduced VE in repeat vaccines, regardless of age, despite high anti-hemagglutinin (HA) titers toward any historic immunizing flu strain [44,45]. The results showing activation of influenza-specific memory B cells upon sequential antigen exposure suggest that antigen relatedness, but not necessarily the duration between antigen exposures, may be a significant factor regarding VE [33,34]. The results also suggest that non-neutralizing antibodies that allow for re-exposure may contribute to the diversification of the memory B cell pool and benefit protection against evolving influenza virus strains [35].…”

mentioning

confidence: 99%

Original Antigenic Sin and Respiratory Syncytial Virus Vaccines

Tripp

Power

2019

Vaccines

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The original antigenic sin (OAS) theory considers the outcome of the first encounter with an antigen. It favors a memory response to the original antigen upon exposure to a similar or related antigen, and includes both positive and negative impacts of past exposure on the memory response to challenge, and, in particular, on vaccine efficacy. This phenomenon is closely linked with imprinting and the hierarchical nature of immune responses to previously encountered antigens. The focus of this commentary centers on the potential role of OAS or immunological imprinting on respiratory syncytial virus memory responses.

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Palivizumab Prophylaxis for Healthy Preterm Infants: More Data Supporting American Academy of Pediatrics Guidelines

Cited by 6 publications

References 11 publications

Uso de Palivizumab en Recién Nacidos Prematuros

Uso de Palivizumab en Recién Nacidos Prematuros

Impact of Adopting 2014 Guidance for Palivizumab Prophylaxis for Children Previously Considered at High Risk for Severe Respiratory Syncytial Virus Disease

Original Antigenic Sin and Respiratory Syncytial Virus Vaccines

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