Respiratory syncytial virus: current and emerging treatment options

Abstract

Respiratory syncytial virus (RSV) is an important respiratory pathogen in infants and children worldwide. Although RSV typically causes mild upper respiratory infections, it frequently causes severe morbidity and mortality, especially in premature infants and children with other chronic diseases. Treatment of RSV is limited by a lack of effective antiviral treatments; however, ribavirin has been used in complicated cases, along with the addition of intravenous immune globulin in specific patients. Vaccination strategies for RSV prevention are heavily studied, but only palivizumab (Synagis®) has been approved for use in the United States in very select patient populations. Research is ongoing in developing additional vaccines, along with alternative therapies that may help prevent or decrease the severity of RSV infections in infants and children. To date, we have not seen a decrement in RSV morbidity and mortality with our current options; therefore, there is a clear need for novel RSV preventative and therapeutic strategies. In this review, we discuss the current and evolving trends in RSV treatment for infants and children.

Respiratory Syncytial Virus–Associated Mortality in Hospitalized Infants and Young Children

“…28 Accurate estimates of mortality in the 21st century can inform costeffectiveness analyses for the use of prophylaxis for the prevention of RSV in high-risk groups and can also be used in the evaluation of experimental preventive and treatment strategies. 29 Mortality is an important variable in economic models. In models that examine the cost-effectiveness of different prophylaxis strategies for the prevention of RSV, mortality rates (when included) drive final costeffectiveness ratios and should not be based on unsupported assumptions.…”

The role of Th17 and Treg responses in the pathogenesis of RSV infection

“…Until an effective RSV vaccine will be licensed, our best preventive alternative consists of passive immunization with antibodies, of which palivizumab is the best known example (96).…”

Respiratory syncytial virus, an ongoing medical dilemma: an expert commentary on respiratory syncytial virus prophylactic and therapeutic pharmaceuticals currently in clinical trials

“…Recent data suggested it may play a role in reducing mortality in this patient cohort . However, its efficacy and safety profile remains controversial due to inconclusive evidence from small, under‐powered studies …”