The Future of Respiratory Syncytial Virus Disease Prevention and Treatment

• Type of Material: Article
• Authors: Joseph B Domachowske, SUNY Upstate Medical University; Evan Anderson, Emory University; Mitchell Goldstein, Loma Linda University Children’s Hospital
• Language: English
• Date: 2021-03-03
• Publisher: SPRINGER LONDON LTD
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2021
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s40121-020-00383-6
• Title of Journal or Parent Work: INFECTIOUS DISEASES AND THERAPY
• Volume: 10
• Issue: SUPPL 1
• Start Page: 47
• End Page: 60
• Grant/Funding Information: This study and the Rapid Service Fees were sponsored by Sobi, Inc.
• Keywords: Treatment; Vaccine; Infectious Diseases; National Perinatal Association; Palivizumab; Monoclonal antibody; Respiratory syncytial virus; Life Sciences & Biomedicine; Immunoprophylaxis; Science & Technology; American Academy of Pediatrics; High-risk preterm infants
• Research Categories: Health Sciences, Public Health; Health Sciences, Health Care Management

Abstract

Respiratory syncytial virus (RSV) is a major cause of respiratory tract infections in infants, young children, and older or immunocompromised adults. Although aerosolized ribavirin was licensed for RSV treatment on the basis of data demonstrating a reduced need for supplemental oxygen, ribavirin use is limited because of issues with efficacy, safety, and cost. Currently, the treatment of RSV is primarily supportive. New antiviral treatments for RSV are in the early stages of development, but it will be years until any of these may be licensed by the US Food and Drug Administration (FDA). Palivizumab, an RSV monoclonal antibody [immunoprophylaxis (IP)], has demonstrated effectiveness in disease prevention and is the only licensed IP for RSV disease in specific high-risk pediatric populations. Although its efficacy is well established, some challenges that may interfere with its clinical use include cost, need for monthly injections, and changing policy for use by the American Academy of Pediatrics (AAP). Preventing RSV disease would be possible through RSV vaccine development (e.g., live-attenuated, vector-based subunit, or particle-based). Alternatively, new long-acting monoclonal antibodies have demonstrated promising results in early clinical trials. Despite scientific advances, until new agents become available, palivizumab should continue to be used to reduce RSV disease burden in high-risk patients for whom it is indicated.