CC BY-NC-ND 4.0 · Am J Perinatol
DOI: 10.1055/a-1990-2633
Original Article

Effectiveness and Safety of Palivizumab for the Prevention of Serious Lower Respiratory Tract Infection Caused by Respiratory Syncytial Virus: A Systematic Review

Tara Gonzales
1   SOBI Inc, Specialty Care North America, Waltham, Massachusetts
,
Aurore Bergamasco 
2   YOLARX Consultants SAS, 101, rue de Sèvres, Paris Cedex 6, France
,
Tiffany Cristarella
3   YOLARX Consultants Inc, 3550 Côte-des-Neiges Road, Montréal, QC, Canada
,
Camille Goyer
3   YOLARX Consultants Inc, 3550 Côte-des-Neiges Road, Montréal, QC, Canada
,
Matthew Wojdyla
1   SOBI Inc, Specialty Care North America, Waltham, Massachusetts
,
Abiola Oladapo
1   SOBI Inc, Specialty Care North America, Waltham, Massachusetts
,
John Sawicky
1   SOBI Inc, Specialty Care North America, Waltham, Massachusetts
,
John Yee
1   SOBI Inc, Specialty Care North America, Waltham, Massachusetts
,
Yola Moride
2   YOLARX Consultants SAS, 101, rue de Sèvres, Paris Cedex 6, France
› Author Affiliations Funding This review was funded by Sobi.
› Further Information
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Abstract

Objective Palivizumab is a humanized monoclonal antibody approved for the prevention of serious lower respiratory tract infection (LRTI) caused by respiratory syncytial virus (RSV) in infants and young children at high risk of RSV disease. This systematic review summarized evidence on the effectiveness and safety of palivizumab when used in approved populations.

Study Design A systematic review of Phase III trials and observational studies was conducted according to the population, intervention, comparator, outcome, timing, setting (PICOTS) approach (PROSPERO, CRD42021281380). Target populations consisted of infants with a history of premature birth (≤35-week gestational age) and children aged <2 years with bronchopulmonary dysplasia (BPD) or with hemodynamically significant congenital heart disease (hs-CHD). Outcomes of interest included RSV-related hospitalization, admission to intensive care unit (ICU), requirement for mechanical ventilation, treatment-related adverse events (AEs), and RSV-related deaths. Information sources were literature search (Ovid MEDLINE and Embase), pragmatic searches, and snowballing (covering the period up to 07 September 2021).

Results A total of 60 sources were included (5 Phase III trials and 55 observational studies). RSV-related hospitalization rates following palivizumab prophylaxis in Phase III trials were 1.8% in premature infants and 7.9% in children with BPD, which were significantly lower than rates in placebo arms. In the real-world setting, similar hospitalization rates were found (0.7–4.0% in premature infants [16 studies] and 0–5.5% in patients with BPD [10 studies]) with ICU admission reported in 0 to 33.3% of patients hospitalized for RSV. In Phase III trials, RSV-related mortality rates were 0.2 and 0.3%, while AEs occurred in 11% of premature and/or BPD patients and 7.2% of hs-CHD patients, consisting mainly of injection site reaction, fever, and diarrhea. Similar results were found in observational studies.

Conclusion This systematic review supports the effectiveness and safety of palivizumab in the indicated populations.

Key Points

  • Systematic review supports the positive benefit-risk profile of palivizumab in the indicated populations.

  • Real-world safety and effectiveness of palivizumab are consistent with Phase III trials results.

  • Palivizumab reduces RSV-related hospitalizations, ICU admissions, and need for mechanical ventilation.

Keywords

systematic review - respiratory syncytial virus - palivizumab - efficacy - effectiveness - safety

Supplementary Material



Publication History

Received: 08 June 2022

Accepted: 09 November 2022

Accepted Manuscript online:
30 November 2022

Article published online:
18 January 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Meng J, Stobart CC, Hotard AL, Moore ML. An overview of respiratory syncytial virus. PLoS Pathog 2014; 10 (04) e1004016
    CrossrefPubMedGoogle Scholar
  • 2 Weisman L. Populations at risk for developing respiratory syncytial virus and risk factors for respiratory syncytial virus severity: infants with predisposing conditions. Pediatr Infect Dis J 2003;22(2, suppl):S33–S37, discussion S37–S39
    PubMedGoogle Scholar
  • 3 Nair H, Nokes DJ, Gessner BD. et al. Global burden of acute lower respiratory infections due to respiratory syncytial virus in young children: a systematic review and meta-analysis. Lancet 2010; 375 (9725): 1545-1555
    CrossrefPubMedGoogle Scholar
  • 4 Moreira LP, Watanabe ASA, Camargo CN, Melchior TB, Granato C, Bellei N. Respiratory syncytial virus evaluation among asymptomatic and symptomatic subjects in a university hospital in Sao Paulo, Brazil, in the period of 2009-2013. Influenza Other Respir Viruses 2018; 12 (03) 326-330
    CrossrefPubMedGoogle Scholar
  • 5 Synagis is the first and only FDA-approved monoclonal antibody for the prevention of severe RSV DISEASE. Synagis (palivizumab) Efficacy and Safety. Accessed October 10, 2022 at: https://synagishcp.com/synagis-palivizumab-efficacy.html
    PubMedGoogle Scholar
  • 6 American Academy of Pediatrics Committee on Infectious Diseases, American Academy of Pediatrics Bronchiolitis Guidelines Committee. Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection. Pediatrics 2014; 134 (02) e620-e638
    CrossrefPubMedGoogle Scholar
  • 7 Goldstein M, Krilov LR, Fergie J. et al. Respiratory syncytial virus hospitalizations among U.S. preterm infants compared with term infants before and after the 2014 American Academy of Pediatrics Guidance on Immunoprophylaxis: 2012-2016. Am J Perinatol 2018; 35 (14) 1433-1442
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Wegzyn C, Toh LK, Notario G. et al. Safety and effectiveness of palivizumab in children at high risk of serious disease due to respiratory syncytial virus infection: a systematic review. Infect Dis Ther 2014; 3 (02) 133-158
    CrossrefPubMedGoogle Scholar
  • 9 Sterne JA, Hernán MA, Reeves BC. et al. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ 2016; 355: i4919
    CrossrefPubMedGoogle Scholar
  • 10 Sterne JA, Savović J, Page MJ. et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ [Online]. 2019. Accessed on December 04, 2021 at: https://methods.cochrane.org/risk-bias-2
    PubMedGoogle Scholar
  • 11 Johanna Briggs Institute. Critical Appraisal Tools. [Online]. Accessed on December 09, 2021 at: http://joannabriggs.org/research/critical-appraisal-tools.html
    PubMedGoogle Scholar
  • 12 IMpact-RSV Study Group. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. Pediatrics 1998; 102 (03) 531-537
    CrossrefPubMedGoogle Scholar
  • 13 Carbonell-Estrany X, Simões EA, Dagan R. et al; Motavizumab Study Group. Motavizumab for prophylaxis of respiratory syncytial virus in high-risk children: a noninferiority trial. Pediatrics 2010; 125 (01) e35-e51
    CrossrefPubMedGoogle Scholar
  • 14 Feltes TF, Cabalka AK, Meissner HC. et al; Cardiac Synagis Study Group. Palivizumab prophylaxis reduces hospitalization due to respiratory syncytial virus in young children with hemodynamically significant congenital heart disease. J Pediatr 2003; 143 (04) 532-540
    CrossrefPubMedGoogle Scholar
  • 15 Turti TV, Baibarina EN, Degtiareva EA. et al. A prospective, open-label, non-comparative study of palivizumab prophylaxis in children at high risk of serious respiratory syncytial virus disease in the Russian Federation. BMC Res Notes 2012; 5 (01) 484
    CrossrefPubMedGoogle Scholar
  • 16 Makari D, Jensen KM, Harris B, Jafri HS. Randomized, double-blind study of the safety of the liquid versus lyophilized formulation of palivizumab in premature infants and children with chronic lung disease of prematurity. Infect Dis Ther 2014; 3 (02) 339-347
    CrossrefPubMedGoogle Scholar
  • 17 Abushahin A, Janahi I, Tuffaha A. Effectiveness of palivizumab immunoprophylaxis in preterm infants against respiratory syncytial virus disease in Qatar. Int J Gen Med 2018; 11: 41-46
    CrossrefPubMedGoogle Scholar
  • 18 Chi H, Hsu CH, Chang JH. et al. A novel six consecutive monthly doses of palivizumab prophylaxis protocol for the prevention of respiratory syncytial virus infection in high-risk preterm infants in Taiwan. PLoS One 2014; 9 (06) e100981
    CrossrefPubMedGoogle Scholar
  • 19 Resch B, Gusenleitner W, Müller WD, Haas J. Observational study of respiratory syncytial virus-associated hospitalizations and use of palivizumab in premature infants aged 29-32 weeks. Eur J Clin Microbiol Infect Dis 2006; 25 (02) 120-122
    CrossrefPubMedGoogle Scholar
  • 20 Viguria N, Navascués A, Juanbeltz R, Echeverría A, Ezpeleta C, Castilla J. Effectiveness of palivizumab in preventing respiratory syncytial virus infection in high-risk children. Hum Vaccin Immunother 2021; 17 (06) 1867-1872
    CrossrefPubMedGoogle Scholar
  • 21 de Souza RP, Ribeiro ALR, de Menezes SAF, Machado LFA. Incidence of respiratory syncytial virus infection in children with congenital heart disease undergoing immunoprophylaxis with palivizumab in Pará state, north region of Brazil. BMC Pediatr 2019; 19 (01) 299
    CrossrefPubMedGoogle Scholar
  • 22 Bar-Yoseph R, Haddad J, Hanna M. et al. Long term follow-up of palivizumab administration in children born at 29-32 weeks of gestation. Respir Med 2019; 150: 149-153
    CrossrefPubMedGoogle Scholar
  • 23 Kusuda S, Koizumi T, Sakai T, Fujimura M, Nishida H, Togari H. Results of clinical surveillance during the Japanese first palivizumab season in 2002-2003. Pediatr Int 2006; 48 (04) 362-368
    CrossrefPubMedGoogle Scholar
  • 24 Prais D, Kaplan E, Klinger G. et al. Short- and long-term pulmonary outcome of palivizumab in children born extremely prematurely. Chest 2016; 149 (03) 801-808
    CrossrefPubMedGoogle Scholar
  • 25 Groothuis JR. Northern Hemisphere Expanded Access Study Group. Safety and tolerance of palivizumab administration in a large Northern Hemisphere trial. Pediatr Infect Dis J 2001; 20 (06) 628-630
    CrossrefPubMedGoogle Scholar
  • 26 Groothuis JR. Safety of palivizumab in preterm infants 29 to 32 weeks' gestational age without chronic lung disease to prevent serious respiratory syncytial virus infection. Eur J Clin Microbiol Infect Dis 2003; 22 (07) 414-417
    CrossrefPubMedGoogle Scholar
  • 27 Paes B, Mitchell I, Li A, Lanctôt KL. CARESS Investigators. A comparative study of respiratory syncytial virus (RSV) prophylaxis in premature infants within the Canadian Registry of Palivizumab (CARESS). Eur J Clin Microbiol Infect Dis 2012; 31 (10) 2703-2711
    CrossrefPubMedGoogle Scholar
  • 28 Li A, Wang DY, Lanctôt KL, Mitchell I, Paes BA. CARESS Investigators. Comparing first- and second-year palivizumab prophylaxis in patients with hemodynamically significant congenital heart disease in the CARESS Database (2005-2015). Pediatr Infect Dis J 2017; 36 (05) 445-450
    CrossrefPubMedGoogle Scholar
  • 29 Yoshihara S, Kusuda S, Mochizuki H, Okada K, Nishima S, Simões EA. C-CREW Investigators. Effect of palivizumab prophylaxis on subsequent recurrent wheezing in preterm infants. Pediatrics 2013; 132 (05) 811-818
    CrossrefPubMedGoogle Scholar
  • 30 Han YM, Seo HJ, Choi SH. et al. Effect of prophylactic palivizumab on admission due to respiratory syncytial virus infection in former very low birth weight infants with bronchopulmonary dysplasia. J Korean Med Sci 2015; 30 (07) 924-931
    CrossrefPubMedGoogle Scholar
  • 31 Lacaze-Masmonteil T, Rozé JC, Fauroux B. French Pediatricians' Group of Sunagis Patients' Name-Based Programs. Incidence of respiratory syncytial virus-related hospitalizations in high-risk children: follow-up of a national cohort of infants treated with palivizumab as RSV prophylaxis. Pediatr Pulmonol 2002; 34 (03) 181-188
    CrossrefPubMedGoogle Scholar
  • 32 Charkaluk ML, Rousseau J, Dehouck-Vallois M. et al. Occurrence and severity of acute respiratory infections during the first year among very preterm infants: an Epipage-2 cohort analysis. Eur J Pediatr 2021; 180 (06) 1833-1840
    CrossrefPubMedGoogle Scholar
  • 33 Manzoni P, Paes B, Lanctôt KL. et al. Outcomes of infants receiving palivizumab prophylaxis for respiratory syncytial virus in Canada and Italy: an international, prospective cohort study. Pediatr Infect Dis J 2017; 36 (01) 2-8
    CrossrefPubMedGoogle Scholar
  • 34 Amitai N, Stafler P, Blau H. et al. Palivizumab following extremely premature birth does not affect pulmonary outcomes in adolescence. Chest 2020; 158 (02) 660-669
    CrossrefPubMedGoogle Scholar
  • 35 Athiraman N, Agarwal R. Palivizumab immunoprophylaxis (PIP) for infants with chronic lung disease (CLD) of prematurity—a prospective observational study. Arch Dis Child 2012; 97 (Suppl. 01) A28-A28
    PubMedGoogle Scholar
  • 36 Soraiz MG, Andres SB, Castro SB. et al. Palivizumab in infants less than 1 year with hemodynamically significant congenital heart disease in Argentina a comparative study with historical control group. Cardiol Young 2017; 27 (04) S165-S6
    PubMedGoogle Scholar
  • 37 Oh PI, Lanctôt KL, Yoon A. et al; Composs Investigators. Palivizumab prophylaxis for respiratory syncytial virus in Canada: utilization and outcomes. Pediatr Infect Dis J 2002; 21 (06) 512-518
    CrossrefPubMedGoogle Scholar
  • 38 Mochizuki H, Kusuda S, Okada K, Yoshihara S, Furuya H, Simões EAF. Scientific Committee for Elucidation of Infantile Asthma. Palivizumab prophylaxis in preterm infants and subsequent recurrent wheezing. Six-year follow-up study. Am J Respir Crit Care Med 2017; 196 (01) 29-38
    CrossrefPubMedGoogle Scholar
  • 39 Parnes C, Guillermin J, Habersang R. et al; Palivizumab Outcomes Registry Study Group. Palivizumab prophylaxis of respiratory syncytial virus disease in 2000-2001: results from The Palivizumab Outcomes Registry. Pediatr Pulmonol 2003; 35 (06) 484-489
    CrossrefPubMedGoogle Scholar
  • 40 Simoes EA, Groothuis JR, Carbonell-Estrany X. et al; Palivizumab Long-Term Respiratory Outcomes Study Group. Palivizumab prophylaxis, respiratory syncytial virus, and subsequent recurrent wheezing. J Pediatr 2007; 151 (01) 34-42 , 42.e1
    CrossrefPubMedGoogle Scholar
  • 41 Paes B, Mitchell I, Li A, Lanctôt KL. Respiratory hospitalizations and respiratory syncytial virus prophylaxis in special populations. Eur J Pediatr 2012; 171 (05) 833-841
    CrossrefPubMedGoogle Scholar
  • 42 Oncel MY, Arayici S, Simsek GK. et al. Risk factors for hospitalization due to lower respiratory tract infection in preterm infants on palivizumab prophylaxis. Iran J Pediatr 2013; 23 (06) 693-700
    PubMedGoogle Scholar
  • 43 AbbVie. Observational program to assess respiratory syncytial virus (RSV) hospitalization rate in population of children at high-risk of serious RSV illness who received palivizumab immunoprophylaxis (SUNRISE). ClinicalTrials.gov. [Online] 2014. Accessed on November 13, 2021 at: https://clinicaltrials.gov/ct2/show/NCT02282982
    PubMedGoogle Scholar
  • 44 Winterstein AG, Hampp C, Kubilis P, Saidi A. Age-dependent effectiveness of RSV immunoprophylaxis. Pharmacoepidemiol Drug Saf 2011; 20: S322-S323
    PubMedGoogle Scholar
  • 45 Buckley BC, Roylance D, Mitchell MP, Patel SM, Cannon HE, Dunn JD. Description of the outcomes of prior authorization of palivizumab for prevention of respiratory syncytial virus infection in a managed care organization. J Manag Care Pharm 2010; 16 (01) 15-22
    PubMedGoogle Scholar
  • 46 Elmasoudi A, Robson T, Badran H, Khalil A. The effect of palivizumab in the incidence rate of hospitalisation for respiratory syncytial virus infection in highrisk preterm infants in Doha, Qatar: three-year retrospective. Pharmacotherapy 2015; 35 (11) e255
    PubMedGoogle Scholar
  • 47 Sorrentino M, Powers T. The Palivizumab Outcomes Study Group. Effectiveness of palivizumab: evaluation of outcomes from the 1998 to 1999 respiratory syncytial virus season. Pediatr Infect Dis J 2000; 19 (11) 1068-1071
    CrossrefPubMedGoogle Scholar
  • 48 Chiu SN, Wang JN, Fu YC. et al. Efficacy of a novel palivizumab prophylaxis protocol for respiratory syncytial virus infection in congenital heart disease: a multicenter study. J Pediatr 2018; 195: 108-114.e1
    CrossrefPubMedGoogle Scholar
  • 49 Blake SM, Tanaka D, Bendz LM, Staebler S, Brandon D. Evaluation of the financial and health burden of infants at risk for respiratory syncytial virus. Adv Neonatal Care 2017; 17 (04) 292-298
    CrossrefPubMedGoogle Scholar
  • 50 Wang DY, Li A, Paes B, Mitchell I, Lanctôt KL. CARESS Investigators. First versus second year respiratory syncytial virus prophylaxis in chronic lung disease (2005-2015). Eur J Pediatr 2017; 176 (03) 413-422
    CrossrefPubMedGoogle Scholar
  • 51 Lee H, Socher R, Bhardwaj A, Graw-Panzer K, Wadowski S. Incidence of wheezing in premature infants who received Synagis (Palivizumab) prophylaxis: ten-year follow-up. American Journal of Respiratory and Critical Care Medicine Conference: American Thoracic Society International Conference, ATS 2010;181
    PubMedGoogle Scholar
  • 52 Yeo KT, Yung CF, Khoo PC. et al. Effectiveness of palivizumab against respiratory syncytial virus hospitalization among preterm infants in a setting with year-round circulation. J Infect Dis 2021; 224 (02) 279-287
    CrossrefPubMedGoogle Scholar
  • 53 Diehl JL, Daw JR, Coley KC, Rayburg R. Medical utilization associated with palivizumab compliance in a commercial and managed Medicaid health plan. J Manag Care Pharm 2010; 16 (01) 23-31
    PubMedGoogle Scholar
  • 54 Quek BH, Khoo PC, Tan PL. Outcomes of palivizumab prophylaxis for respiratory syncytial virus (RSV) infection in preterm children with bronchopulmonary dysplasia in a country with no seasonal RSV peaks. Journal of Perinatal Medicine Conference: 12th World Congress of Perinatal Medicine 2015;43:Suppl.1
    PubMedGoogle Scholar
  • 55 Chang SG, Park MS, Yu JE. Outcomes of palivizumab prophylaxis for respiratory syncytial virus infection in preterm children with bronchopulmonary dysplasia at a single hospital in Korea from 2005 to 2009. J Korean Med Sci 2010; 25 (02) 251-256
    CrossrefPubMedGoogle Scholar
  • 56 Lee SR, Kwok KL, Ng DKK, Hon KL. Palivizumab for infants < 29 weeks in Hong Kong without a clear-cut season for respiratory syncytial virus infection—a cost-effectiveness analysis. J Trop Pediatr 2018; 64 (05) 418-425
    CrossrefPubMedGoogle Scholar
  • 57 Taylor RS, Baker MH. Palivizumab prophylaxis for infants 29 to 32 weeks gestation at birth: a 10-year audit from Vancouver Island using BC Guidelines. Paediatr Child Health 2020; 26 (02) e110-e114
    CrossrefPubMedGoogle Scholar
  • 58 Krilov LR, Masaquel AS, Weiner LB, Smith DM, Wade SW, Mahadevia PJ. Partial palivizumab prophylaxis and increased risk of hospitalization due to respiratory syncytial virus in a Medicaid population: a retrospective cohort analysis. BMC Pediatr 2014; 14 (01) 261
    CrossrefPubMedGoogle Scholar
  • 59 Mitchell I, Paes B, Li A, Chen J, Lanctôt KL. Respiratory illness and respiratory syncytial virus hospitalizations in the Canadian Registry for Synagis (CARESS) over eight seasons (2005–2013). Paediatr Child Health 2014; 19 (06) e49
    CrossrefPubMedGoogle Scholar
  • 60 Mitchell I, Abraha H, Li A, Paes B, Lanctot K. Respiratory related hospitalizations in premature infants prophylaxed with palivizumab In the Canadian registry of palivizumab (CARESS). European Respiratory Journal Conference 2015;46
    PubMedGoogle Scholar
  • 61 Resch B, Bramreiter VS, Kurath-Koller S, Freidl T, Urlesberger B. Respiratory syncytial virus associated hospitalizations in preterm infants of 29 to 32 weeks gestational age using a risk score tool for palivizumab prophylaxis. Eur J Clin Microbiol Infect Dis 2017; 36 (06) 1057-1062
    CrossrefPubMedGoogle Scholar
  • 62 Fang L, Wang J. Respiratory syncytial virus immunoprophylaxis and asthma symptoms development in prematurity with bronchopulmonary dysplasia. Allergy 2018; 73: 310-311
    PubMedGoogle Scholar
  • 63 Chadha AD, Bao W, Holloway J, Mann J, Rye AK, Brown III DE. Respiratory syncytial virus morbidity and outpatient palivizumab dosing in South Carolina, 2004-2009. South Med J 2012; 105 (08) 399-404
    CrossrefPubMedGoogle Scholar
  • 64 Paes B, Kim D, Saleem M, Wong S, Mitchell I, Lanctot KL. and the CARESS investigators. Respiratory syncytial virus prophylaxis in infants with congenital airway anomalies compared to standard indications and complex medical disorders. Eur J Pediatr 2019; 178 (03) 377-385
    CrossrefPubMedGoogle Scholar
  • 65 Lavoie P, Claydon J, Popescu C. et al. Respiratory syncytial virus-related outcomes from an abbreviated palivizumab dose regimen in children with congenital heart disease. Paediatr Child Health 2019; 24 (Suppl. 02) e16-e17
    CrossrefPubMedGoogle Scholar
  • 66 Paes B, Mitchell I, Li A, Harimoto T, Lanctôt KL. Respiratory-related hospitalizations following prophylaxis in the Canadian registry for palivizumab (2005-2012) compared to other international registries. Clin Dev Immunol 2013; 2013: 917068
    CrossrefPubMedGoogle Scholar
  • 67 Bonnet D, Prahl R, Fredrick LM, Schulz GA, Campbell AL, Notario G. Retrospective analysis suggests palivizumab prophylaxis is not associated with an increased risk of serious infection, serious arrhythmia, or death in pediatric patients <24 months of age with hemodynamically significant congenital heart disease (HSCHD). Acta Paediatr 2011; 100: 59
    PubMedGoogle Scholar
  • 68 Kim AY, Jung SY, Choi JY. et al. Retrospective multicenter study of respiratory syncytial virus prophylaxis in Korean children with congenital heart diseases. Korean Circ J 2016; 46 (05) 719-726
    CrossrefPubMedGoogle Scholar
  • 69 Lin YJ, Chung CH, Chi H, Lin CH. Six-monthly palivizumab prophylaxis effectively reduced RSV-associated hospitalization rates of preterm infants in a subtropical area: a population-based cohort study. Pediatr Res 2019; 86 (05) 628-634
    CrossrefPubMedGoogle Scholar
  • 70 Claydon J, Popescu CR, Shaiba L. et al. Outcomes related to respiratory syncytial virus with an abbreviated palivizumab regimen in children with congenital heart disease: a descriptive analysis. CMAJ Open 2019; 7 (01) E88-E93
    CrossrefPubMedGoogle Scholar
  • 71 Pedraz C, Carbonell-Estrany X, Figueras-Aloy J, Quero J. IRIS Study Group. Effect of palivizumab prophylaxis in decreasing respiratory syncytial virus hospitalizations in premature infants. Pediatr Infect Dis J 2003; 22 (09) 823-827
    CrossrefPubMedGoogle Scholar
  • 72 Ryan R. Heterogeneity and subgroup analyses in Cochrane Consumers and Communication Group reviews: planning the analysis at protocol stage. Cochrane Consumers and Communication Review Group. December 2016. Accessed 28 June 2019 at: http://cccrg.cochrane.org
    PubMedGoogle Scholar