Meta-analysis of the efficacy of palivizumab versus nirsevimab at preventing medically attended respiratory syncytial virus infections in non-hospitalized preterm infants

Palivizumab has >27 y of proven effectiveness in the prevention of severe respiratory syncytial virus (RSV) infection in high-risk infants. However, there remains limited data on its efficacy at preventing medically attended, non-hospitalized RSV infections (MARI). A systematic literature review was undertaken to identify randomized, placebo-controlled studies of prophylactic interventions against MARI and RSV-related hospitalization in healthy infants born ≤35 weeks' gestational age (wGA). The findings informed a meta-analysis of three studies (N = 2,464) that found palivizumab significantly reduced MARI by 70.5% compared with placebo in 29-35 wGA infants, with broadly similar efficacy to nirsevimab.