Clinical Report: Effectiveness and Safety of Monoclonal Antibodies for RSV

Overview

This systematic review and network meta-analysis evaluated the efficacy and safety of monoclonal antibodies (mAbs) for treating respiratory syncytial virus (RSV) in premature infants. Nirsevimab, motavizumab, and palivizumab significantly reduced RSV-related hospitalizations and ICU admissions.

Background

Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in infants, particularly in preterm infants who are at higher risk for severe disease. Effective prevention strategies, such as monoclonal antibodies, are crucial for reducing the burden of RSV-related complications in this vulnerable population.

Data Highlights

Key Findings

• Nirsevimab, motavizumab, and palivizumab reduced RSV-related hospitalizations in preterm infants compared to placebo.
• Nirsevimab showed the highest SUCRA values for both hospitalization (94.4%) and ICU admissions (89.1%).
• No significant differences were found in mechanical ventilation use or deaths related to RSV infections among the treatments.
• All three mAbs demonstrated a favorable safety profile with no significant drug-related adverse events reported.

Clinical Implications

The findings indicate the use of nirsevimab, motavizumab, and palivizumab in preventing severe RSV disease in premature infants.

Conclusion

Monoclonal antibodies are effective in reducing RSV-related hospitalizations and ICU admissions in preterm infants.

Related Resources & Content

1. JAMA Pediatrics, 2023 -- RSV Antibody Prophylaxis Needs for Extremely Preterm Infants in Their Second RSV Season
2. Open Forum Infectious Diseases, 2023 -- Comprehensive Review and Expert Recommendations on Long-acting Monoclonal Antibodies for Preventing Respiratory Syncytial Virus Infection: Insights from the ARMADA Taskforce
3. The Journal of Infectious Diseases, 2023 -- A Phase 1b/2a Study Assessing the Safety and Efficacy of Clesrovimab, a Long-Lasting Neutralizing Antibody for Respiratory Syncytial Virus, in Healthy Infants Born Preterm and Full-term
4. CDC MMWR, 2025 -- Use of Clesrovimab for Prevention of Severe Respiratory Syncytial Virus–Associated Lower Respiratory Tract Infections in Infants: Recommendations of the Advisory Committee on Immunization Practices
5. New England Journal of Medicine, 2025 -- Clesrovimab for Prevention of RSV Disease in Healthy Infants
6. International Journal of Infectious Diseases — Prevention of respiratory syncytial virus bronchiolitis in infants with maternal immunization or monoclonal antibodies for the newborn: What do women choose?
7. CDC Guidance on RSV Prophylaxis
8. Clesrovimab for Prevention of RSV Disease in Healthy Infants | New England Journal of Medicine
9. Nirsevimab Effectiveness Against Intensive Care Unit Admission for Respiratory Syncytial Virus in Infants — 24 States, December 2024–April 2025 | MMWR