[Benefits of home-based administration of palivizumab in high-risk groups].

Carolina Ortiz, Ignacia Vásquez, Alejandra Zamorano, Ivonne D'Apremont, Enrica Pittaluga, Marcela Díaz, Catalina Campos
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Abstract

Palivizumab, a humanized monoclonal antibody against the respiratory syncytial virus (RSV), currently is indicated in groups at higher risk of developing severe RSV disease, such as extreme premature infants and patients with hemodynamically significant heart disease. In Chile, this strategy is guaranteed by Law 20850 (Ricarte Soto Law). Nevertheless, barriers to its administration included the need to transfer these labile patients and exposure to other users, with the risk of contagion in waiting rooms.

Objective: to describe the impact of the palivizumab administration strategy in a home care program for high-risk patients.

Patients and method: retrospective, descriptive, observational cohort study of patients born before 32 weeks of gestation or weighing less than 1500 grams, who received palivizumab between January 2019 and December 2021 at the Hospital Dr. Sótero del Río.

Results: 272 patients were included (median gestational age: 30 weeks). The percentage of doses administered at home was 35.9% (2019) and 37.2% (2021). Each dose of 2020 following the administration in Neonatology, was administered at home during the COVID-19 pandemic. The median interval between doses was as recommended. Adherence was over 90%. The unadjusted incidence of RSV infection was 5.7% (2019), 0% (2020), and 0.9% (2021).

Conclusions: palivizumab administration was adequate and timely; home indication was associated with high adherence rates and an administration interval between doses in line with current recommendations.

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[高危人群家庭给药帕利珠单抗的益处]。
Palivizumab是一种抗呼吸道合胞病毒(RSV)的人源化单克隆抗体,目前用于发生严重RSV疾病风险较高的人群,如极度早产儿和血液动力学显著的心脏病患者。在智利,这一战略受到第20850号法律(Ricarte Soto法)的保障。然而,其管理的障碍包括需要转移这些不稳定的病人,并与其他使用者接触,在候诊室有传染的风险。目的:描述帕利珠单抗给药策略对高危患者家庭护理计划的影响。患者和方法:回顾性、描述性、观察性队列研究,研究对象是在2019年1月至2021年12月期间在Sótero del Río医院接受帕利珠单抗治疗的妊娠32周前出生或体重小于1500克的患者。结果:纳入272例患者(中位胎龄:30周)。在家给药的比例分别为35.9%(2019年)和37.2%(2021年)。在2019冠状病毒病大流行期间,在新生儿学给药后的2020年每剂都在家中给药。剂量之间的中位数间隔是推荐的。依从性超过90%。未经调整的RSV感染发生率分别为5.7%(2019年)、0%(2020年)和0.9%(2021年)。结论:帕利珠单抗给药充分、及时;家庭适应症与高依从率和符合当前建议的给药间隔有关。
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