Motavizumab for the prevention of respiratory syncytial virus infection in infants

Background: Respiratory syncytial virus (RSV) is the most important respiratory viral pathogen of infancy. The only unequivocally effective pharmacological compound for the management of RSV infection is palivizumab, a monoclonal antibody against the fusion protein of RSV. Recently, motavizumab, a similar but more potent monoclonal antibody, has been developed and tested against palivizumab. Objective: In this review, we summarize data comparing the safety and efficacy of the two monoclonal antibodies in prevention of RSV infection. Other therapeutic options also are discussed. Methods: We reviewed all published articles listing motavizumab or palivizumab in the title or keywords. Results/conclusion: In a large comparative clinical trial for which peer review is pending, motavizumab proved noninferior to palivizumab for prevention of RSV-related hospital admission in infants with underlying conditions placing them at high risk for hospitalization after RSV infection. In this trial, motavizumab in comparison to palivizumab significantly reduced the severity of illness among those infants hospitalized with RSV infection, as well as the number of outpatient lower respiratory infections caused by RSV. Safety profiles of each of the two compounds were excellent. Based on these data, motavizumab should eventually replace palivizumab in the prevention of RSV infection.