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Infectious Diseases and Therapy
Published in: Infectious Diseases and Therapy 1/2018

Open Access 01-03-2018 | Review

Past, Present and Future Approaches to the Prevention and Treatment of Respiratory Syncytial Virus Infection in Children

Authors: Eric A. F. Simões, Louis Bont, Paolo Manzoni, Brigitte Fauroux, Bosco Paes, Josep Figueras-Aloy, Paul A. Checchia, Xavier Carbonell-Estrany

Published in: Infectious Diseases and Therapy | Issue 1/2018

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Abstract

Introduction

The REGAL (RSV Evidence – A Geographical Archive of the Literature) series has provided a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This seventh and final publication covers the past, present and future approaches to the prevention and treatment of RSV infection among infants and children.

Methods

A systematic review was undertaken of publications between January 1, 1995 and December 31, 2017 across PubMed, Embase and The Cochrane Library. Studies reporting data on the effectiveness and tolerability of prophylactic and therapeutic agents for RSV infection were included. Study quality and strength of evidence (SOE) were graded using recognized criteria. A further nonsystematic search of the published literature and Clinicaltrials.gov on antiviral therapies and RSV vaccines currently in development was also undertaken.

Results

The systematic review identified 1441 studies of which 161 were included. Management of RSV remains centered around prophylaxis with the monoclonal antibody palivizumab, which has proven effective in reducing RSV hospitalization (RSVH) in preterm infants < 36 weeks’ gestational age (72% reduction), children with bronchopulmonary dysplasia (65% reduction), and infants with hemodynamically significant congenital heart disease (53% reduction) (high SOE). Palivizumab has also shown to be effective in reducing recurrent wheezing following RSVH (high SOE). Treatment of RSV with ribavirin has conflicting success (moderate SOE). Antibodies with increased potency and extended half-life are currently entering phase 3 trials. There are approximately 15 RSV vaccines in clinical development targeting the infant directly or indirectly via the mother.

Conclusion

Palivizumab remains the only product licensed for RSV prophylaxis, and only available for high-risk infants. For the general population, there are several promising vaccines and monoclonal antibodies in various stages of clinical development, with the aim to significantly reduce the global healthcare impact of this common viral infection.

Funding

AbbVie.
Appendix
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Metadata
Title
Past, Present and Future Approaches to the Prevention and Treatment of Respiratory Syncytial Virus Infection in Children
Authors
Eric A. F. Simões
Louis Bont
Paolo Manzoni
Brigitte Fauroux
Bosco Paes
Josep Figueras-Aloy
Paul A. Checchia
Xavier Carbonell-Estrany
Publication date
01-03-2018
Publisher
Springer Healthcare
Published in
Infectious Diseases and Therapy / Issue 1/2018
Print ISSN: 2193-8229
Electronic ISSN: 2193-6382
DOI
https://doi.org/10.1007/s40121-018-0188-z

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