Synagis: an anti-RSV monoclonal antibody

Palivizumab is a new anti-RSV monoclonal antibody product indicated for the prevention of serious lower respiratory tract disease caused by RSV in pediatric patients at high risk of developing RSV disease ("Synagis," 1998). Palivizumab was evaluated in a single, large clinical trial (IMpact) (Connor et al., 1998). In this trial, RSV hospital admissions were reduced by 55% in children 24 months of age with BPD or in infants born prematurely (35 weeks gestation). Additionally, the severity of illness was also reduced as evidenced by a decrease in total days of RSV hospitalization and decreased incidence of RSV intensive care unit admissions. Palivizumab is expensive--with an estimated cost for a season ranging from $3,500-$10,700 per infant, depending on the child's weight and length of RSV season in the area where the child resides. Although palivizumab prophylaxis has been shown to reduce hospital admissions, the cost effectiveness of using this product needs to be formally evaluated. The AAP has provided guidance to determine the best candidates for RSV prophylaxis.