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Review
. 2025 Jul 2;12(7):ofaf396.
doi: 10.1093/ofid/ofaf396. eCollection 2025 Jul.

Systematic Review and Expert Consensus on the Use of Long-acting Monoclonal Antibodies for Prevention of Respiratory Syncytial Virus Disease: ARMADA (Advancing RSV Management And Disease Awareness) Taskforce

Paolo Manzoni  1   2 , Eugenio Baraldi  3   4 , Fabio Midulla  5 , Olivier Claris  6   7 , Sandro Dessardo  8 , Terho Heikkinen  9 , Richard Thwaites  10 , Bosco Paes  11 , Xavier Carbonell-Estrany  12 , Dmytro Dobryanskyy  13 , Merih Cetinkaya  14 , Adel S Al Harbi  15 , Ji-Man Kang  16   17 , Anne Goh Eng Neo  18 , Hsin Chi  19   20 , Guilherme Sant'Anna  21 , Mónica Villa Guillén  22   23 , Gonzalo Luis Mariani  24 , Marco Aurelio Palazzi Safadi  25 , Soledad Urzua  26 , Heather J Zar  27   28 , Pierre Goussard  29   30 , Barry Rodgers-Gray  31 , Nicola Waghorne  31 , Manuel Sanchez Luna  32
Affiliations
Review

Systematic Review and Expert Consensus on the Use of Long-acting Monoclonal Antibodies for Prevention of Respiratory Syncytial Virus Disease: ARMADA (Advancing RSV Management And Disease Awareness) Taskforce

Paolo Manzoni et al. Open Forum Infect Dis. .

Abstract

Background: Long-acting monoclonal antibodies (LAmAbs) could dramatically reduce the respiratory syncytial virus (RSV) disease burden in children if implemented using clear, evidence-based recommendations.

Methods: The ARMADA Taskforce-an international, multidisciplinary expert panel-undertook a systematic review to develop LAmAbs consensus recommendations for RSV disease prevention in children.

Results: The Taskforce recommends LAmAbs for all infants aged <8 months in the absence of maternal RSV vaccination, preterm infants (<37 weeks' gestational age) aged <12 months, and children <24 months with high-risk conditions. Seasonal LAmAb administration is recommended, although in RSV-endemic countries decisions should be made locally concerning administration year-round or with peak RSV incidences.

Conclusions: The Taskforce strongly endorses LAmAbs implementation based on their efficacy, effectiveness, and public health impact. These recommendations provide a blueprint to inform guidelines worldwide. Wider equitable access to LAmAbs at affordable prices, especially in low- and middle-income countries is needed to reduce the childhood RSV burden.

Keywords: disease prevention; long-acting monoclonal antibodies (LAmAbs); public health impact; respiratory syncytial virus (RSV).

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Conflict of interest statement

Potential conflicts of interest. P.M. has received research funding and/or compensation as advisor/lecturer from AstraZeneca, Moderna, GSK, Pfizer, and Sanofi and is a member of ReSViNET. E.B. has received fees for lectures and advisory boards from Sanofi, AstraZeneca, and Chiesi. T.H. has received fees for lectures and/or participation in advisory boards or data monitoring committees from Sanofi, MSD, Pfizer, and Moderna, and he is a member of ReSViNET. R.T. has completed consultancy work for AstraZeneca. A.G.E.N. has received honoraria for participating in advisory boards from Sanofi and AstraZeneca. M.C. has been an advisory board member for AstraZeneca. M.A.P.S. has received honoraria for lectures and/or participation in advisory boards or data monitoring committees from Sanofi, AstraZeneca, Abbvie, Pfizer, and GSK. H.J.Z. has received funding for studies on RSV prevention studies to institution in infants from Pfizer, Novavax, AstraZeneca, MSD; DSMB of Moderna; Advisory board MSD, and Pfizer. B.R.G./N.W.'s employer has previously received payment for work on various projects from AbbVie, AstraZeneca, and Sanofi. X.C.E. has received consultancy fees from Pfizer. B.P. has received consultancy and speaker fees from AstraZeneca and Sanofi. M.S..L has received consultancy fees, and paid lectures from AstraZeneca and Sanofi, and paid lectures from Pfizer. The remaining authors have nothing to declare.

Figures

Figure 1.
Figure 1.
PRISMA diagram. Evidence for the use of LAmAbs in RSV infection. Abbreviations: LAmAbs, long-acting monoclonal antibodies; PK, pharmacokinetics; RCT, randomized controlled trial; RSV, respiratory syncytial virus.
See this image and copyright information in PMC

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