Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hóspital Clínico Universitario de Santiago de Compostela, University of Santiago, La Coruña, Padova, Italy.
Lancet Respir Med. 2015 Nov;3(11):888-900. doi: 10.1016/S2213-2600(15)00255-6. Epub 2015 Sep 25.
Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in children under five years of age. Evidence-based management guidelines suggest that there is no effective treatment for RSV lower respiratory tract infection (LRTI) and that supportive care, ie, hydration and oxygenation, remains the cornerstone of clinical management. However, RSV treatments in development in the past decade include 10 vaccines and 11 therapeutic agents in active clinical trials. Maternal vaccination is particularly relevant because the most severe disease occurs within the first 6 months of life, when children are unlikely to benefit from active immunisation. We must optimise the implementation of novel RSV therapeutics by understanding the target populations, showing safety, and striving for acceptable pricing in the context of this worldwide health problem. In this Review, we outline the limitations of RSV LRTI management, the drugs in development, and the remaining challenges related to study design, regulatory approval, and implementation.
呼吸道合胞病毒（RSV）是五岁以下儿童发病率和死亡率的主要全球原因。循证管理指南表明，目前尚无有效的 RSV 下呼吸道感染（LRTI）治疗方法，支持性护理，即补液和氧疗，仍然是临床管理的基石。然而，过去十年中开发的 RSV 治疗方法包括 10 种疫苗和 11 种在积极临床试验中的治疗药物。母体疫苗接种尤其重要，因为最严重的疾病发生在生命的前 6 个月内，此时儿童不太可能从主动免疫中受益。我们必须通过了解目标人群、展示安全性并在这一全球健康问题的背景下努力实现可接受的定价，来优化新型 RSV 治疗方法的实施。在这篇综述中，我们概述了 RSV LRTI 管理的局限性、正在开发的药物以及与研究设计、监管批准和实施相关的剩余挑战。
