TY - JOUR
T1 - Respiratory syncytial virus prevention within reach
T2 - the vaccine and monoclonal antibody landscape
AU - Mazur, Natalie I.
AU - Terstappen, Jonne
AU - Baral, Ranju
AU - Bardají, Azucena
AU - Beutels, Philippe
AU - Buchholz, Ursula J.
AU - Cohen, Cheryl
AU - Crowe, James E.
AU - Cutland, Clare L.
AU - Eckert, Linda
AU - Feikin, Daniel
AU - Fitzpatrick, Tiffany
AU - Fong, Youyi
AU - Graham, Barney S.
AU - Heikkinen, Terho
AU - Higgins, Deborah
AU - Hirve, Siddhivinayak
AU - Klugman, Keith P.
AU - Kragten-Tabatabaie, Leyla
AU - Lemey, Philippe
AU - Libster, Romina
AU - Löwensteyn, Yvette
AU - Mejias, Asuncion
AU - Munoz, Flor M.
AU - Munywoki, Patrick K.
AU - Mwananyanda, Lawrence
AU - Nair, Harish
AU - Nunes, Marta C.
AU - Ramilo, Octavio
AU - Richmond, Peter
AU - Ruckwardt, Tracy J.
AU - Sande, Charles
AU - Srikantiah, Padmini
AU - Thacker, Naveen
AU - Waldstein, Kody A.
AU - Weinberger, Dan
AU - Wildenbeest, Joanne
AU - Wiseman, Dexter
AU - Zar, Heather J.
AU - Zambon, Maria
AU - Bont, Louis
N1 - Copyright © 2023 Elsevier Ltd. All rights reserved.
PY - 2023/1
Y1 - 2023/1
N2 - Respiratory syncytial virus is the second most common cause of infant mortality and a major cause of morbidity and mortality in older adults (aged >60 years). Efforts to develop a respiratory syncytial virus vaccine or immunoprophylaxis remain highly active. 33 respiratory syncytial virus prevention candidates are in clinical development using six different approaches: recombinant vector, subunit, particle-based, live attenuated, chimeric, and nucleic acid vaccines; and monoclonal antibodies. Nine candidates are in phase 3 clinical trials. Understanding the epitopes targeted by highly neutralising antibodies has resulted in a shift from empirical to rational and structure-based vaccine and monoclonal antibody design. An extended half-life monoclonal antibody for all infants is likely to be within 1 year of regulatory approval (from August, 2022) for high-income countries. Live-attenuated vaccines are in development for older infants (aged >6 months). Subunit vaccines are in late-stage trials for pregnant women to protect infants, whereas vector, subunit, and nucleic acid approaches are being developed for older adults. Urgent next steps include ensuring access and affordability of a respiratory syncytial virus vaccine globally. This review gives an overview of respiratory syncytial virus vaccines and monoclonal antibodies in clinical development highlighting different target populations, antigens, and trial results.
AB - Respiratory syncytial virus is the second most common cause of infant mortality and a major cause of morbidity and mortality in older adults (aged >60 years). Efforts to develop a respiratory syncytial virus vaccine or immunoprophylaxis remain highly active. 33 respiratory syncytial virus prevention candidates are in clinical development using six different approaches: recombinant vector, subunit, particle-based, live attenuated, chimeric, and nucleic acid vaccines; and monoclonal antibodies. Nine candidates are in phase 3 clinical trials. Understanding the epitopes targeted by highly neutralising antibodies has resulted in a shift from empirical to rational and structure-based vaccine and monoclonal antibody design. An extended half-life monoclonal antibody for all infants is likely to be within 1 year of regulatory approval (from August, 2022) for high-income countries. Live-attenuated vaccines are in development for older infants (aged >6 months). Subunit vaccines are in late-stage trials for pregnant women to protect infants, whereas vector, subunit, and nucleic acid approaches are being developed for older adults. Urgent next steps include ensuring access and affordability of a respiratory syncytial virus vaccine globally. This review gives an overview of respiratory syncytial virus vaccines and monoclonal antibodies in clinical development highlighting different target populations, antigens, and trial results.
KW - Aged
KW - Antibodies, Monoclonal/therapeutic use
KW - Antibodies, Viral
KW - Female
KW - Humans
KW - Immunization
KW - Infant
KW - Pregnancy
KW - Respiratory Syncytial Virus Infections/prevention & control
KW - Respiratory Syncytial Virus Vaccines
KW - Respiratory Syncytial Virus, Human
UR - http://www.scopus.com/inward/record.url?scp=85136720386&partnerID=8YFLogxK
U2 - 10.1016/S1473-3099(22)00291-2
DO - 10.1016/S1473-3099(22)00291-2
M3 - Review article
C2 - 35952703
AN - SCOPUS:85136720386
SN - 1473-3099
VL - 23
SP - e2-e21
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 1
ER -