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Monoclonal Antibody Treatment of RSV Bronchiolitis in Young Infants: A Randomized Trial

Khalid Alansari1,2,3, Fatihi Hassan Toaimah4, Daher Helmi Almatar4

  • 1Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation, Doha, Qatar; dkmaa@hotmail.com.

Pediatrics
|February 15, 2019
PubMed

Insights

Palivizumab (monoclonal antibody) did not improve outcomes for young infants hospitalized with respiratory syncytial virus (RSV) bronchiolitis. This study found no significant difference in readmission rates or hospital discharge times between palivizumab and placebo groups.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Immunology

Background:

  • Monoclonal antibody palivizumab is recommended for respiratory syncytial virus (RSV) prophylaxis in high-risk infants.
  • Its efficacy for treating established RSV bronchiolitis in young infants is not well-established.

Purpose of the Study:

  • To evaluate the effectiveness of palivizumab for treating acute RSV bronchiolitis in infants.
  • To determine if palivizumab impacts readmission rates, hospital discharge time, or PICU admission in infants with RSV bronchiolitis.

Main Methods:

  • A double-blind, randomized trial involving infants ≤3 months old with RSV-positive bronchiolitis requiring hospitalization.
  • Participants received a single intravenous dose of palivizumab (15 mg/kg) or a placebo.
  • Primary outcome was 3-week inpatient readmission; secondary outcomes included time to discharge readiness and PICU admission.

Main Results:

  • No significant difference in readmission rates between palivizumab (11%) and placebo (9.3%) groups (P = .51).
  • Similar geometric mean time to readiness for hospital discharge for both groups (29.5 vs 30.2 hours).
  • No safety concerns were reported with palivizumab administration.

Conclusions:

  • Intravenous palivizumab did not demonstrate a benefit in treating acute RSV bronchiolitis in young infants.
  • Palivizumab was found to be safe but ineffective for this indication.
Abstract

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