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Infections
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
The antibody directed against the G protein of the RS virus shows a strong capacity for the neutralisation of the A and B variants of the RS virus in vitro. A preparation of these antibodies is commercially available under the name of palivizumab. Palivizumab is prescribed for premature infants under six months of age and for children under two years of age with bronchopulmonary dysplasia during the six months that precede the epidemic season. The recommended dose is 15 mg/kg/month IM. The half life is 30 days and the duration of protection is between one and two months. Its effectiveness has been proven in a number of studies [2].
Respiratory syncytial virus (RSV)
Published in Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward, Case Studies in Infectious Disease, 2010
Peter M. Lydyard, Michael F. Cole, John Holton, William L. Irving, Nino Porakishvili, Pradhib Venkatesan, Katherine N. Ward
Immunoprophylaxis: A humanized monoclonal antibody directed against the F protein of RSV (palivizumab) can be used as passive immunoprophylaxis to protect especially vulnerable infants. However, it is of limited benefit and expensive. For anyone other than an infant immunoprophylaxis with palivizumab is impractical, as the amount of antibody required is prohibitively expensive.
Accident and Emergency
Published in Nagi Giumma Barakat, Get Through, 2006
Palivizumab is a monoclonal antibody licensed for monthly use to prevent RSV infections in infants who were born at 35 weeks of gestation or less and are still under 6 months of age at the start of the RSV season and children less than 2 years old who have received treatment for bronchopulmonary dysplasia within the last 6 months.
The mechanism and pharmacodynamics of 2-((1H-indol-3-yl)thio/sulfinyl)-N-pheny acetamide derivative as a novel inhibitor against human respiratory syncytial virus
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2022
Ningning Cheng, Nan Jiang, Yuanhui Fu, Zhuxin Xu, Xianglei Peng, Jiemei Yu, Shan Cen, Yucheng Wang, Guoning Zhang, Yanpeng Zheng, Jinsheng He
Human respiratory syncytial virus (RSV) is an enveloped, negative-sense, single-stranded RNA virus and belongs to the Pneumovirus family and the Orthopneumovirus genus1–4. It is 15.2 kb in length and contains 10 genes encoding 11 proteins, NS1, NS2, N, P, M, SH, G, F, M2-1, M2-2, and L5–8. RSV is a leading cause of lower respiratory tract infection in nearly all children by 2-year-old globally and it was estimated that there were 3.2 million hospitalised cases and about 60,000 deaths annually9–12. RSV is also an important pathogen of severe lower respiratory tract disease in the elderly and adults with immunodeficiency disorders13,14. Unfortunately, there is no safe and effective vaccine licenced against RSV infection. Only ribavirin and palivizumab are the available drugs for the treatment of RSV infection15–18. Yet, being a broad-spectrum antiviral drug, ribavirin is not recommended due to its poor efficacy and side effects. Palivizumab, a costly humanised monoclonal antibody for RSV, can only be used to prevent RSV infection for the young and high-risk children born prematurely, with chronic lung disease or congenital heart disease19–21. Therefore, the development of safe and effective anti RSV drugs has important clinical significance22–24.
Emerging small and large molecule therapeutics for respiratory syncytial virus
Published in Expert Opinion on Investigational Drugs, 2020
Harrison C. Bergeron, Ralph A. Tripp
While RSV vaccine development aims to reduce RSV infection by inducing protective antibodies that can be recalled upon infection, alternatives to managing RSV disease are also needed and include preventative and prophylactic therapeutics (Table 1) [46]. Palivizumab (Synagis®), a humanized monoclonal antibody targeting the F protein, is an FDA-approved prescription injection of antibodies that is given monthly to help protect high-risk infants from severe RSV disease throughout the RSV season [47]. Studies have shown that palivizumab reduces hospitalizations in treated infants by approximately 50%, although its efficacy decreases as mutations in F protein are induced by treatment [48,49]. Moreover, it is not useful in reducing asthma that may develop post-RSV infection [50]. Palivizumab has practical limitations including its exclusionary target population, i.e. high-risk or premature infants. In addition, palivizumab treatment is costly – a 100-mg dose is ~1900 USD and must be administered using monthly dosing regimens during the RSV season, and more importantly, the treatment is not fully effective. Unfortunately, palivizumab treatment has the inability to prevent asthma-associated RSV infections [51,52] and has not demonstrated efficacy as a post-infection therapy [53]. The only other approved antiviral is ribavirin, a nucleoside analog [54,55]. Ribavirin has shown mixed to poor results [56,57], thus to date there remains a need for more efficacious RSV therapeutics.
Respiratory syncytial virus prophylaxis for children with chronic lung disease: have we got the criteria right?
Published in Expert Review of Anti-infective Therapy, 2019
Bosco Paes, Xavier Carbonell-Estrany
The IMpact, randomized, placebo-controlled trial conclusively demonstrated the efficacy and safety of palivizumab in the prevention of respiratory syncytial virus (RSV) infection-related hospitalization. The US Food and Drug Administration federal agency and the European Medicines Evaluation Agency, quickly recognized the utility of palivizumab and recommended its use in preterm infants’ ≤35 wGA and those with CLD and hemodynamically significant congenital heart disease. The criterion for the use of palivizumab in CLD was standardized based on the IMpact trial and included children ≤24 months requiring ongoing medical treatment (supplemental oxygen, steroids, bronchodilators, or diuretics), 6 months prior to the onset of the RSV season. At the time, in 1996, this perhaps correctly singled out children with relatively severe CLD based on the original Northway classification from 1967 [11,105]. The description of oxygen dependency at 28 days of age as being chronic was arbitrary and reflected the course of respiratory distress syndrome without mechanical ventilation [105]. The cut off at 28 days was incorporated by the bureau of Maternal and Child Health Resources Development [106] and was implemented in clinical practice until the present, executive, consensus workshop recommendations that focus on the persistence of radiographic, parenchymal lung disease, at 36 weeks post menstrual age [19].