Original clinical scienceOral versus inhaled ribavirin therapy for respiratory syncytial virus infection after lung transplantation
Section snippets
Methods
The Cleveland Clinic Institutional Review Board approved this study.
Results
Initially, 30 RSV-positive patients were identified, but 4 were excluded due to absence of BOS data and 4 due to enrollment in an interventional RSV treatment study. One additional patient received both oral and inhaled ribavirin and was also excluded.
Discussion
RSV infection after lung transplantation is common (up to 21%) in adults, and the mortality rate of RSV infection in this population remains at 10% to 20%, despite advances in supportive therapy.7, 8 Moreover, RSV infection in lung transplant recipients has been associated with severe lower respiratory tract infections, BOS progression, and both poor short-term and long-term outcomes.1, 3, 20 Kumar et al20 detected biopsy-proved acute rejection or a decline in FEV1 ≥ 20% in 33.3% of lung
Disclosure statement
Dr Budev is the site investigator for an Alnylam RSV study at the Cleveland Clinic. None of the authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
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2021, Transplantation ProceedingsCitation Excerpt :Some authors used a weight-adjusted dosage of 15 to 20 mg/kg/d 2 or 3 times for 10 to 14 days. Other groups administered standard dosages such as Li et al who used 400 mg every 8 hours for 5 to 10 days [13] or Marcelin et al who used 600-800 every 12 hours for 10 days [8]. In the study of Burrows et al an intravenous loading dosage (33 mg/kg/d in 2 times) was given on the first day followed by oral RBV at 20 mg/kg/d in 2 times for a minimum of 6 days [10].
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2021, Journal of Controlled ReleaseCitation Excerpt :Similarly, when considering oral versus nebulized ribavirin, nebulized ribavirin is less likely to induce systemic side effects including hemolytic anemia and GIT discomfort [60]. However, other route related adverse effects were reported with nebulized ribavirin such as cough, nasal congestion, and dyspnea [60]. While systemic side effects were observed with antiviral drugs targeting viral components (Table 1), drugs that target host proteins may cause, (depending on administration route and dose) even more undesired side effects, given the wider availability of their target in non-targeted organs [77].