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Hi, my name is Vik Anand. I'm a Pediatric Infectious Disease Specialist at Cedars Sinai Medical Center. I'm here with my colleague, Dr. Priya Soni.
Hi Vik. Thank you so much. Today we're going to be talking about RSV, discussing some of the history of vaccinations with RSV, as well as monoclonal antibodies that are currently in use as well as those on the horizon.
The reason, you know, why this is so important is because RSV continues to be a major cause of hospitalizations, as well as deaths within children less than 5 years old specifically, as well as adults that are above 65. You know, it's led to annually in this country 100 to 500 deaths annually in children less than 5 years of age, as well as 14,000 deaths in adults annually. So this is a big, big issue still, and this infection continues to be a big problem for us.
Yeah, the hope has always been for vaccination to prevent illness. And vaccination works for - in a lot of situations. Unfortunately, when people tried, back in the 1960s, to try and just create a vaccine from the whole virus inactivated, and gave it to children, it actually made the problem worse. And so that created a lot of anxiety in terms of making vaccines, especially with the fear that you would actually make the clinical syndrome worse, through some unclear mechanism. And obviously, a lot of research was poured into it to looking at the fusion protein and its exact chemistry. And by doing so, people were able to identify a confirmation of the fusion protein that will actually neutralize RSV. And the hope is, of course, that with the new vaccines, that it won't lead to this.
And we have a lot of exciting new clinical trials in terms of the vaccines showing pretty good efficacy, especially in adults right now. There's two recent studies in adults showing very good virus - vaccine efficacy against preventing RSV disease. And there's even studies in pregnant women showing that transference of immunity to children does seem to protect the children themselves as well. But obviously, you know, vaccination won't necessarily work for everyone, and especially with the concern that that exists with it.
What are the other preventive measures we have for RSV? And what's on the horizon?
Sure, yeah. Thank you for that. So currently, there's one approved monoclonal antibody that we administer for high-risk infants, which is called palivizumab. And palivizumab has to be given in multiple doses during RSV and respiratory season. And it's really aimed for and targeted towards a small group of high-risk infants that are at risk for severe disease. And so you can imagine the challenges with a monthly infusion administration of this.
So something exciting that is coming up, hopefully, is nirsevimab, which is an investigational single-dose, long-acting antibody that's developed to provide protection for lower respiratory tract infection caused by RSV in these infants. And so there have been some really great studies to kind of look at this.
As well as, thirdly, a last monoclonal called clesrovimab, which is an investigational RSV fusion glycoprotein neutralizing monoclonal antibody, that's undergoing current phase 3 evaluations as well.
So these are very exciting sort of options that will hopefully have able to provide our high-risk infants in the future.
And that new monoclonal is sort of targeting that same fusion protein that the vaccines are targeting as well. Is that correct?
Correct. Yes, clesrovimab is definitely with that same target for the fusion protein. So this is exciting.
Well, thank you so much for joining with me, Priya, and talking about RSV and the future of RSV therapeutics. This was great.
Very exciting. Thank you so much, Vik. And hopefully everyone was able to learn something. Thank you.
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