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¿Es Palivizumabe un factor protector para el desarrollo del asma en niños? Una revisión sistemática con el
Mariana Bueno Manini1, Natali Caroline da Silva1, Rafaela Agra de Castro2
1Child and Adolescent Health Postgraduate Program, State University of Campinas, Campinas, São Paulo, Brazil.
Pediatric pulmonology
|August 22, 2025
Resumen
La profilaxis con palivizumab no previene el asma en niños prematuros sin problemas cardíacos. Este medicamento reduce principalmente las infecciones graves por virus sincitial respiratorio (VSR), no el desarrollo del asma infantil.
Área de la Ciencia:
- Pulmonología pediátrica
- Neonatología
- Inmunología clínica
Sus antecedentes:
- Los bebés prematuros enfrentan un mayor riesgo de problemas respiratorios crónicos e infecciones graves como el RSV.
- Se sabe que palivizumab mitiga la gravedad del RSV en niños de alto riesgo, pero su efecto sobre el desarrollo del asma no está bien establecido.
Objetivo del estudio:
- Revisar y metaanalizar sistemáticamente la literatura existente.
- Determinar si la profilaxis con palivizumab protege a los niños prematuros (sin enfermedad cardíaca congénita) de desarrollar asma.
Principales métodos:
- Revisión sistemática y metanálisis de 14 estudios.
- Se incluyeron datos de 1.364.238 niños, de los cuales 9232 recibieron palivizumab.
- Se realizaron análisis de subgrupos y de sensibilidad para evaluar la robustez y las poblaciones específicas.
Principales resultados:
- No hubo diferencias significativas en el desarrollo del asma entre los pacientes tratados con palivizumab y los controles (OR 0,84, p=0,1968).
- El análisis de subgrupos para el historial de atopia tampoco mostró una reducción significativa del riesgo de asma.
- Los lactantes tratados con palivizumab fueron diagnosticados más jóvenes, pero las diferencias en la edad gestacional no fueron significativas.
Conclusiones:
- La profilaxis con palivizumab no disminuye el riesgo de asma en niños prematuros sin enfermedad cardíaca congénita.
- El beneficio establecido de palivizumab es la prevención de infecciones graves por VSR, no la prevención de la aparición de asma.
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