Efectividad del nirsevimab en la prevención de infección por virus sincitial respiratorio en lactantes: revisión sistemática

Abstract

Introduction: Respiratory syncytial virus (RSV) constitutes one of the main causes of lower respiratory tract infections in infants, associated with high morbidity and mortality and high hospitalization rates, especially in those under six months of age and in patients with comorbidities. Globally and in Ecuador, it represents a major public health problem due to the increase in bronchiolitis and pneumonia, in addition to the economic impact on healthcare systems. Given this problem, monoclonal antibodies such as nirsevimab have emerged as a promising preventive strategy to reduce infections and associated complications. Objective: To determine the effectiveness of nirsevimab in the prevention of lower respiratory tract infections in infants. Methods: Phase 3 and 4 double- and triple-blind studies published between 2019 and 2024 in English and Spanish were included. These studies evaluated the effectiveness of nirsevimab compared with palivizumab and placebo for the prevention of lower respiratory infections caused by RSV. Databases such as Cochrane Library, PubMed, Scopus, LILACS, PLOS ONE, and documents from health organizations were consulted. The risk of bias and quality were assessed using RoB 2.0 and the NIH tool respectively. Results: A total of 10 clinical trials were included with an average of 2,000 infants per study. Nirsevimab reduced RSV infections by up to 79.5%, hospitalizations by 77.3% and clinical severity by 86%. Conclusions: Nirsevimab proved to be safe and more effective than palivizumab, decreasing consultations, hospitalizations and clinical severity, with a half-life of up to five months. Keywords: Bronchiolitis., Infants, Viral Pneumonia, Respiratory Syncytial Virus Vaccines, Human Respiratory Syncytial Virus