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Adherence and outcomes: a systematic review of palivizumab utilization

Sophie K Wong1, Abby Li1, Krista L Lanctôt1

  • 1a Medical Outcomes and Research in Economics (MORE®) Research Group, Sunnybrook Health Sciences Centre, University of Toronto , Toronto , ON , Canada.

Expert Review of Respiratory Medicine
|November 14, 2017
PubMed

Insights

Consistent adherence to monthly palivizumab dosing is crucial for respiratory syncytial virus (RSV) prophylaxis in young children. This review highlights the need for standardized definitions of adherence to improve evidence on palivizumab effectiveness.

Area of Science:

  • Pediatric Infectious Diseases
  • Immunology
  • Pharmacology

Background:

  • Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in children under two years old.
  • Palivizumab, a monoclonal antibody, is used for RSV prophylaxis, requiring strict monthly dosing for efficacy.
  • Inconsistent adherence can reduce palivizumab's effectiveness and increase the risk of RSV infection and hospitalization.

Purpose of the Study:

  • To review the variability in defining and reporting adherence to palivizumab prophylaxis across studies.
  • To assess the relationship between adherence to monthly dosing protocols and reported outcomes in published trials.

Main Methods:

  • Literature review of studies on palivizumab efficacy and safety.
  • Analysis of adherence definitions and reporting in randomized controlled trials.
  • Assessment of outcome data in relation to adherence to monthly dosing schedules.

Main Results:

  • Significant variability exists in the definition and reporting of palivizumab adherence.
  • A clear relationship between adherence and outcomes needs further investigation due to inconsistent reporting.
  • Lack of standardized adherence metrics complicates the interpretation of palivizumab effectiveness.

Conclusions:

  • Standardized, detailed reporting of palivizumab adherence is essential for robust evidence.
  • Consistent definitions will aid in understanding effectiveness variations and informing guidelines.
  • Improved adherence data can impact cost-effectiveness analyses and clinical recommendations.
Abstract

Keywords:
Adherencecomplianceepidemiologymonoclonal antibodypalivizumabprophylaxisrespiratory syncytial virusrespiratory tract infection

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