From the Guidelines
Treatment options for Respiratory Syncytial Virus (RSV) infection in pediatric patients with Williams syndrome are limited to prevention with monoclonal antibodies, such as nirsevimab or palivizumab, for high-risk patients.
Prevention
- Nirsevimab is a long-acting monoclonal antibody approved for passive immunization to prevent RSV-associated lower respiratory tract infection among infants and young children, including those with underlying conditions like Williams syndrome 1.
- Palivizumab is another monoclonal antibody that has been used for RSV prophylaxis in high-risk infants, including those with hemodynamically significant heart disease, which may be relevant to patients with Williams syndrome 1.
Patient Selection
- The American Academy of Pediatrics (AAP) recommends palivizumab prophylaxis for infants and young children at increased risk of severe RSV disease, including those with certain underlying medical conditions 1.
- However, the AAP also notes that the majority of RSV hospitalizations occur among healthy term infants, and palivizumab immunoprophylaxis will have only a minimal effect on the burden of RSV disease 1.
Special Considerations
- For children in the second year of life, palivizumab prophylaxis is not recommended unless they have chronic lung disease of infancy and continue to require supplemental oxygen, chronic corticosteroid therapy, or diuretic therapy within 6 months of the onset of the second RSV season 1.
- Nirsevimab can be administered from October through the end of March in most of the continental United States, based on pre–COVID-19 pandemic patterns 1.
From the Research
Treatment Options for RSV Infection
The treatment options for Respiratory Syncytial Virus (RSV) infection in pediatric patients, including those with Williams syndrome, are primarily supportive, with a focus on managing symptoms and preventing complications.
- Supportive care, such as administration of supplemental oxygen and fluid replacement therapy, is the mainstay of treatment 2
- Bronchodilators may be beneficial for some patients 2
- Antiviral therapy with aerosolized ribavirin may be considered for high-risk, severely ill patients 3, 4, 2
- Palivizumab, an RSV monoclonal antibody, has been shown to be effective in preventing RSV disease in high-risk pediatric populations, including premature infants and those with certain underlying medical conditions 3, 4, 2
Prevention Strategies
Prevention of RSV infection is also an important consideration, particularly in high-risk populations.
- Handwashing, cleaning of environmental surfaces, and cohorting in hospital settings may help decrease RSV transmission 2
- Palivizumab may be used as a preventive measure in high-risk infants and young children during the RSV season 3, 4, 2
- Research is ongoing into the development of RSV vaccines, which may provide active immunity against the virus 3, 5, 4, 6