Monoclonal antibody treatment improves outcomes of respiratory syncytial virus infection outcomes in infants

Without a discernible increase in adverse events, nirsevimab, motavizumab, and palivizumab were linked to significant improvements in the prevention of respiratory syncytial virus (RSV) infection, says an article published in the Journal of American Medical Association.

Effective preventative methods are desperately needed since respiratory syncytial virus is the main cause of acute lower respiratory infections in children under the age of five. In order to compare the effectiveness and safety of monoclonal antibodies for the prevention of RSV infection in newborns and children, Mingyao Sun and colleagues did this study.

Embase, PubMed, CENTRAL, and ClinicalTrials.gov were all searched in this systematic review and network meta-analysis from the beginning of the database up until March 2022. Infants at a high risk of RSV infection were included in randomized clinical studies in which they were randomly assigned to either a monoclonal antibody or a placebo. RSV, randomized clinical trials, and monoclonal antibodies were all searched for using rich vocabulary and keywords.

The key findings of this study were:

The eligible studies included 15 randomized clinical trials with 18 395 children; 14 of these studies were synthesized, with a total of 18 042 participants. 

Nirsevimab, palivizumab, and motavizumab were linked to considerably lower RSV-related infections per 1000 participants and RSV-related hospitalizations per 1000 participants when compared to placebo, according to moderate- to high-certainty evidence. 

Motavizumab, palivizumab, and nirsevimab were all related with considerably lower rates of supplementary oxygen usage and intensive care unit hospitalizations per 1000 individuals, according to moderately strong evidence, whereas palivizumab was also linked to a considerable drop in these rates. 

There were no discernible differences between drug-related adverse events and all-cause mortality. 

Suptavumab failed to provide any appreciable advantages for the targeted outcomes.

According to these results, palivizumab, nirsevimab, and motavizumab may all help to lower the incidence of RSV infections and hospitalizations. Similar outcomes were seen in the amount of extra oxygen used. Palivizumab was solely linked with a decrease in ICU admissions; motavizumab was associated with substantial variations in both the rate of MV usage and ICU admissions.

Reference:

Sun, M., Lai, H., Na, F., Li, S., Qiu, X., Tian, J., Zhang, Z., & Ge, L. (2023). Monoclonal Antibody for the Prevention of Respiratory Syncytial Virus in Infants and Children. In JAMA Network Open (Vol. 6, Issue 2, p. e230023). American Medical Association (AMA). https://doi.org/10.1001/jamanetworkopen.2023.0023