Systematic review of the safety and efficacy of palivizumab among infants and young children with cystic fibrosis

Kok Pim Kua, Shaun Wen Huey Lee

    Research output: Contribution to journalReview ArticleResearchpeer-review

    13 Citations (Scopus)

    Abstract

    Background: Respiratory syncytial virus (RSV) is a common pathogen in infants with cystic fibrosis (CF). The use of palivizumab prophylaxis for RSV infection as the standard of care for infants with CF remains controversial. Objective: To evaluate the efficacy of palivizumab in reducing the incidence of RSV hospitalization in children with CF who are younger than 2 years. Methods: Four electronic databases (PubMed, Embase, CINAHL, and CENTRAL) were searched from inception until January 31, 2017, for clinical studies investigating the use of palivizumab in infants with CF aged less than 2 years. The primary outcome was hospitalization rate due to RSV infection. Secondary outcomes included hospitalization for respiratory illness, length of hospital stay, safety (adverse effects), and cost-effectiveness of palivizumab prophylaxis. Results: The review included a total of 10 studies (six cohort studies, two before-and-after studies, one cross-sectional study, and one randomized controlled trial) involving 3891 patients with CF. Seven studies reported that palivizumab prophylaxis had a positive impact on the rate of RSV hospitalization. Five studies (n=3404) reported that palivizumab prophylaxis significantly reduced the rate of hospitalization due to RSV infection compared to no prophylaxis. One study (n=5) demonstrated patients with CF who received palivizumab had no RSV hospitalization. Another study showed infants with CF receiving palivizumab (n=117) had a lower risk of hospitalization for RSV infection compared with premature infants (gestational age < 35 completed weeks) who received palivizumab (n=4880). Conclusions: Evidence from the literature suggests that palivizumab may have a potential role in reducing RSV hospitalization in children aged less than 2 years with CF. Given the lack of overall data, additional research is warranted to better understand the efficacy and safety of prophylactic palivizumab in infants with CF.

    Original languageEnglish
    Pages (from-to)755-769
    Number of pages15
    JournalPharmacotherapy
    Volume37
    Issue number6
    DOIs
    Publication statusPublished - Jun 2017

    Keywords

    • bronchiolitis
    • children
    • cystic fibrosis
    • drug information
    • infectious disease
    • palivizumab
    • pediatrics
    • prophylaxis
    • pulmonary
    • respiratory syncytial virus

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