Palivizumab

{{Short description|Pharmaceutical drug}} {{cs1 config|name-list-style=vanc|display-authors=6}} {{Drugbox | Verifiedfields = changed | verifiedrevid = 458269701 | image =

| type = mab | mab_type = mab | source = zu/o | target = RSV protein F

| tradename = Synagis | Drugs.com = {{drugs.com|monograph|palivizumab}} | MedlinePlus = a698034 | licence_EU = yes | DailyMedID = Palivizumab | pregnancy_AU = | pregnancy_category = | routes_of_administration = Intramuscular | ATC_prefix = J06 | ATC_suffix = BD01 | ATC_supplemental =

| legal_AU = S4 | legal_AU_comment = <ref>{{Cite web | title=SYNAGIS palivizumab (rmc) 100 mg / 1 mL solution for injection vial (231139) {{!}} Therapeutic Goods Administration (TGA) | url=https://www.tga.gov.au/resources/artg/231139 | archive-url=https://web.archive.org/web/20231231074815/https://www.tga.gov.au/resources/artg/231139 | access-date=2025-03-18 | archive-date=2023-12-31}}</ref> | legal_BR =  | legal_BR_comment = | legal_CA =  | legal_CA_comment = | legal_DE =  | legal_DE_comment = | legal_NZ =  | legal_NZ_comment = | legal_UK = POM | legal_UK_comment = <ref name="Synagis SmPC">{{cite web | title=Synagis 100 mg/ml solution for injection - Summary of Product Characteristics (SmPC) | website=(emc) | date=12 August 2020 | url=https://www.medicines.org.uk/emc/product/6963/smpc | access-date=20 August 2020}}</ref> | legal_US = Rx-only | legal_US_comment = <ref name="Synagis FDA label">{{cite web | title=Synagis- palivizumab injection, solution | website=DailyMed | date=12 May 2017 | url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8e35c4c8-bf56-458f-a73c-8f5733829788 | access-date=20 August 2020}}</ref> | legal_EU = Rx-only | legal_EU_comment = <ref name="Synagis EPAR" /> | legal_UN =  | legal_UN_comment = | legal_status = Rx-only

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| C=6470 | H=10056 | N=1700 | O=2008 | S=50 }} '''Palivizumab''', sold under the brand name '''Synagis''', is a monoclonal antibody produced by recombinant DNA technology used to prevent severe disease caused by respiratory syncytial virus (RSV) infections.<ref name="Synagis SmPC" /><ref name="Synagis EPAR" /> It is recommended for infants at high-risk for RSV due to conditions such as prematurity or other medical problems including heart or lung diseases.<ref name="Synagis SmPC" /><ref name="Synagis EPAR" />

The most common side effects include fever and rash.<ref name="Synagis SmPC" /><ref name="Synagis EPAR">{{cite web | title=Synagis EPAR | website=European Medicines Agency (EMA) | date=17 September 2018 | url=https://www.ema.europa.eu/en/medicines/human/EPAR/synagis | access-date=20 August 2020}} Text was copied from this source which is copyright European Medicines Agency. Reproduction is authorized provided the source is acknowledged.</ref>

Palivizumab is a humanized monoclonal antibody (IgG) directed against an epitope in the A antigenic site of the F protein of RSV. In two phase III clinical trials in the pediatric population, palivizumab reduced the risk of hospitalization due to RSV infection by 55% and 45%.<ref>{{Cite journal|date=2021|title=Prospective Study for the Use of Palivizumab (Synagis®) in High-risk Children in Germany|url=https://clinicaltrials.gov/ct2/show/NCT01155193 |website=ClinicalTrials.gov}}</ref> Palivizumab is dosed once a month via intramuscular (IM) injection to be administered throughout the RSV season,<ref name="Synagis SmPC" /> which tends to start in late autumn or early winter in temperate climates and follows more complicated seasonal patterns in tropical regions.<ref>{{cite journal | vauthors = Borchers AT, Chang C, Gershwin ME, Gershwin LJ | title = Respiratory syncytial virus--a comprehensive review | journal = Clinical Reviews in Allergy & Immunology | volume = 45 | issue = 3 | pages = 331–379 | date = December 2013 | pmid = 23575961 | pmc = 7090643 | doi = 10.1007/s12016-013-8368-9 }}</ref><ref>{{Cite web|last=CDC|date=2020-12-18|title=Trends and Surveillance for RSV in the US.|url=https://www.cdc.gov/rsv/research/us-surveillance.html|access-date=2021-08-10|website=Centers for Disease Control and Prevention|language=en-us}}</ref>

Palivizumab targets the fusion protein of RSV,<ref>{{cite book | vauthors = Levinson W | title = Medical Microbiology and Immunology | url = https://archive.org/details/medicalmicrobiol00warr_0 | url-access = registration | edition = 8th | publisher = Lange | date = 2004 | page = [https://archive.org/details/medicalmicrobiol00warr_0/page/430 430] | isbn = 978-0-07-143199-6 }}</ref> inhibiting its entry into the cell and thereby preventing infection. Palivizumab was approved for medical use in 1998.<ref>{{cite book | vauthors = Long SS, Pickering LK, Prober CG |title=Principles and Practice of Pediatric Infectious Disease |date=2012 |publisher=Elsevier Health Sciences |isbn=978-1-4377-2702-9 |page=1502 |url=https://books.google.com/books?id=nQ7-o8JAH7kC&pg=PA1502|language=en}}</ref>

== Medical use== Palivizumab is indicated for the prevention of serious lower respiratory tract disease requiring hospitalization caused by the respiratory syncytial virus (RSV) in children at high risk for RSV disease:<ref name="Synagis SmPC" /><ref name="Synagis EPAR" /><ref>{{cite journal | vauthors = Santos da Silva GN, Monti Atik D, Antunes Fernandes JL, de Freitas do Nascimento D, Fazolo T, Duarte de Souza AP, Baggio Gnoatto SC | title = Synthesis of three triterpene series and their activity against respiratory syncytial virus | journal = Archiv der Pharmazie | volume = 351 | issue = 8 | article-number = e1800108 | date = July 2018 | pmid = 29999539 | doi = 10.1002/ardp.201800108 | hdl-access = free | s2cid = 51621538 | hdl = 10923/21468 }}</ref> * children born at 35 weeks of gestation or less and less than six months of age at the onset of the RSV season;<ref name="Synagis EPAR" /> * children less than two years of age and requiring treatment for bronchopulmonary dysplasia within the last six months;<ref name="Synagis EPAR" /> * children less than two years of age and with hemodynamically significant congenital heart disease.<ref name="Synagis EPAR" />

The American Academy of Pediatrics has published guidelines for the use of palivizumab. The most recent updates to these recommendations are based on new information regarding RSV seasonality, palivizumab pharmacokinetics, the incidence of bronchiolitis hospitalizations, the effect of gestational age and other risk factors on RSV hospitalization rates, the mortality of children hospitalized with RSV infection, the effect of prophylaxis on wheezing, and palivizumab-resistant RSV isolates.<ref name="Brady_2014">{{cite journal | vauthors = Brady MT, Byington CL, Davies HD, Edwards KM, Jackson MA, Maldonado YA, Murray DL, Orenstein WA, Rathore MH, Sawyer MH, Schutze GE | title = Updated guidance for palivizumab prophylaxis among infants and young children at increased risk of hospitalization for respiratory syncytial virus infection | journal = Pediatrics | volume = 134 | issue = 2 | pages = 415–420 | date = August 2014 | pmid = 25070315 | doi = 10.1542/peds.2014-1665 | collaboration = American Academy of Pediatrics Committee on Infectious Diseases; American Academy of Pediatrics Bronchiolitis Guidelines Committee. | doi-access = free }}</ref>

=== RSV Prophylaxis === All infants younger than one year who were born at <29 weeks (i.e. ≤28 weeks, 6 days) of gestation are recommended to use palivizumab. Infants younger than one year with bronchopulmonary dysplasia (i.e. who were born at <32 weeks gestation and required supplemental oxygen for the first 28 days after birth) and infants younger than two years with bronchopulmonary dysplasia who require medical therapy (e.g. supplemental oxygen, glucocorticoids, diuretics) within six months of the anticipated RSV season are recommended to use palivizumab as prophylaxis.<ref name="Brady_2014" /> Taking palivizumab prophylactically decreases the number of RSV infections, decreases wheezing, and may decrease the rate of hospitalization attributed to RSV.<ref name="Andabaka_2013">{{cite journal | vauthors = Andabaka T, Nickerson JW, Rojas-Reyes MX, Rueda JD, Bacic Vrca V, Barsic B | title = Monoclonal antibody for reducing the risk of respiratory syncytial virus infection in children | journal = The Cochrane Database of Systematic Reviews | issue = 4 | article-number = CD006602 | date = April 2013 | pmid = 23633336 | doi = 10.1002/14651858.cd006602.pub4 }}</ref><ref name="Garegnani_2025">{{cite journal | vauthors = Garegnani L, Roson Rodriguez P, Escobar Liquitay CM, Esteban I, Franco JV | title = Palivizumab for preventing severe respiratory syncytial virus (RSV) infection in children | journal = The Cochrane Database of Systematic Reviews | volume = 2025 | issue = 7 | article-number = CD013757 | date = July 2025 | pmid = 40698576 | pmc = 12284916 | doi = 10.1002/14651858.CD013757.pub3 | pmc-embargo-date = July 23, 2026 }}</ref> There are few negative side effects reported.<ref name="Garegnani_2025" /> It is not clear if palivizumab is effective and safe for the other medical conditions that put them at a higher risk for serious cases of RSV such as deficiencies in their immune system.<ref name="Garegnani_2025" />

Since the risk of RSV decreases after the first year following birth, the use of palivizumab for children more than 12 months of age is generally not recommended with the exception of premature infants who need supplemental oxygen, bronchodilator therapy, or steroid therapy at the time of their second RSV season.<ref name="Brady_2014" />

==== RSV Prophylaxis Target Groups ==== * Infants younger than one year of age with hemodynamically significant congenital heart disease. * Infants younger than one year of age with neuromuscular disorders impairing the ability to clear secretions from the upper airways or pulmonary abnormalities. * Children younger than two years of age who are immunocompromised (e.g. those with severe combined immunodeficiency; those younger than two years of age who have undergone lung transplantation or hematopoietic stem cell transplantation) during the RSV season. * Children with Down syndrome who have additional risk factors for lower respiratory tract infections such as congenital heart disease, chronic lung disease, or premature birth.<ref name="Brady_2014" /> * Alaska Native and American Indian infants. Decisions regarding palivizumab prophylaxis for children in these groups should be made on a case-by-case basis.<ref name="Brady_2014" />

=== RSV Treatment === Because palivizumab is a passive antibody, it is ineffective in the treatment of RSV infection, and its administration is not recommended for this indication.<ref name="Brady_2014" /> A 2019 (updated in 2023) Cochrane review found no differences in palivizumab and placebo on outcomes of mortality, length of hospital stay, and adverse events in infants and children aged up to 3 years old with RSV.<ref>{{cite journal | vauthors = Sanders SL, Agwan S, Hassan M, Bont LJ, Venekamp RP | title = Immunoglobulin treatment for hospitalised infants and young children with respiratory syncytial virus infection | journal = The Cochrane Database of Systematic Reviews | volume = 2023 | issue = 10 | article-number = CD009417 | date = October 2023 | pmid = 37870128 | pmc = 10591280 | doi = 10.1002/14651858.CD009417.pub3 }}</ref> Larger RCTs will be required before palivizumab can be recommended as a treatment option.<ref>{{cite journal | vauthors = Hu J, Robinson JL | title = Treatment of respiratory syncytial virus with palivizumab: a systematic review | journal = World Journal of Pediatrics | volume = 6 | issue = 4 | pages = 296–300 | date = November 2010 | pmid = 21080142 | doi = 10.1007/s12519-010-0230-z | s2cid = 22504710 }}</ref> If an infant has an RSV infection despite the use of palivizumab during the RSV season, monthly doses of palivizumab may be discontinued for the rest of the RSV season due to the low risk of re-hospitalization.<ref name="Brady_2014" /> Current studies are in progress to determine new treatments for RSV rather than solely prophylaxis.<ref>{{cite journal | vauthors = Ferla S, Manganaro R, Benato S, Paulissen J, Neyts J, Jochmans D, Brancale A, Bassetto M | title = Rational modifications, synthesis and biological evaluation of new potential antivirals for RSV designed to target the M2-1 protein | journal = Bioorganic & Medicinal Chemistry | volume = 28 | issue = 8 | article-number = 115401 | date = April 2020 | pmid = 32143992 | doi = 10.1016/j.bmc.2020.115401 | s2cid = 212622222 | url = https://lirias.kuleuven.be/bitstream/123456789/652873/3/BMC_RSV_2020_main_Accepted.pdf }}</ref>

== Contraindications == Contraindications for the use of palivizumab include hypersensitivity reactions upon exposure to palivizumab. Serious cases of anaphylaxis have been reported after exposure to palivizumab. Signs of hypersensitivity include hives, shortness of breath, hypotension, and unresponsiveness. No other contraindications for palivizumab have been reported.<ref>{{Cite web|title=Drugs@FDA: FDA-Approved Drugs|url=https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=103770 |access-date=28 July 2021|website=www.accessdata.fda.gov}}</ref> Further studies are needed to determine if any drug-drug interactions exist as none have been conducted as of yet.

== Side effects == Palivizumab use may cause side effects, which include, but are not limited to:<ref>{{cite web|title = Palivizumab Injection | work = MedlinePlus Drug Information|url = https://www.medlineplus.gov/druginfo/meds/a698034.html| publisher = U.S. National Library of Medicine |access-date = 2016-01-30}}</ref> * Sore throat * Runny nose * Injection site reactions including redness or irritation * Vomiting * Diarrhea Some more serious side effects include: * Severe skin rash * Itching * Hives (urticaria) * Difficulty breathing

==Pharmacology== === Pharmacodynamics === Palivizumab has demonstrated a significantly higher affinity and potency in neutralizing both A and B subtypes of RSV when compared with RSV-IGIV.<ref>{{cite book | vauthors = Wu H, Pfarr DS, Losonsky GA, Kiener PA | chapter = Immunoprophylaxis of RSV Infection: Advancing from RSV-IGIV to Palivizumab and Motavizumab | series = Current Topics in Microbiology and Immunology | title = Human Antibody Therapeutics for Viral Disease | volume = 317 | pages = 103–123 | date = 2008 | pmid = 17990791 | doi = 10.1007/978-3-540-72146-8_4 | isbn = 978-3-540-72144-4 }}</ref> Treatment with 2.5 mg/kg of palivizumab led to a serum concentration of 25-30 μg/mL in cotton rats and reduced RSV titers by 99% in their lungs.<ref name="Resch_2017">{{cite journal | vauthors = Resch B | title = Product review on the monoclonal antibody palivizumab for prevention of respiratory syncytial virus infection | journal = Human Vaccines & Immunotherapeutics | volume = 13 | issue = 9 | pages = 2138–2149 | date = September 2017 | pmid = 28605249 | pmc = 5612471 | doi = 10.1080/21645515.2017.1337614 }}</ref>

==== Mechanism of action ==== Palivizumab is a monoclonal antibody that targets the fusion (F) glycoprotein on the surface of RSV, and deactivates it.<ref name="Resch_2017"/> The F protein is a membrane protein responsible for fusing the virus with its target cell and is highly conserved among subgroups of RSV. Deactivating the F protein prevents the virus from fusing with its target's cell membrane and prevents the virus from entering the host cell.<ref name="Resch_2017" /><ref>{{cite book | vauthors = McLellan JS, Ray WC, Peeples ME | chapter = Structure and Function of Respiratory Syncytial Virus Surface Glycoproteins | series = Current Topics in Microbiology and Immunology | title = Challenges and Opportunities for Respiratory Syncytial Virus Vaccines | volume = 372 | pages = 83–104 | date = 2013 | pmid = 24362685 | pmc = 4211642 | doi = 10.1007/978-3-642-38919-1_4 | isbn = 978-3-642-38918-4 }}</ref>

=== Pharmacokinetics ===

==== Absorption ==== A 2008 meta-analysis found that palivizumab absorption was quicker in the pediatric population compared to adults (''k<sub>a</sub> ='' 1.01/day vs. ''k<sub>a</sub> ='' 0.373/day). The intramuscular bioavailability of this drug is approximately 70% in healthy young adults.<ref name="Robbie_2012">{{cite journal | vauthors = Robbie GJ, Zhao L, Mondick J, Losonsky G, Roskos LK | title = Population pharmacokinetics of palivizumab, a humanized anti-respiratory syncytial virus monoclonal antibody, in adults and children | journal = Antimicrobial Agents and Chemotherapy | volume = 56 | issue = 9 | pages = 4927–4936 | date = September 2012 | pmid = 22802243 | pmc = 3421858 | doi = 10.1128/AAC.06446-11 }}</ref> Current recommendation for RSV immunoprophylaxis is administration of 5 x 15 mg/kg doses of palivizumab to maintain body concentrations above 40 μg/mL.<ref>{{cite journal | vauthors = Reuter SE, Evans AM, Ward MB | title = Reducing Palivizumab Dose Requirements Through Rational Dose Regimen Design | journal = CPT: Pharmacometrics & Systems Pharmacology | volume = 8 | issue = 1 | pages = 26–33 | date = January 2019 | pmid = 30426719 | pmc = 6363066 | doi = 10.1002/psp4.12364 }}</ref>

==== Distribution ==== The volume of distribution is approximately 4.1 liters.<ref name="Robbie_2012" />

==== Clearance ==== Palivizumab has a drug clearance (CL) of approximately 198 ml/day. The half-life of this drug is approximately 20 days with three doses sustaining body concentrations that will last the entire RSV season (5 to 6 months). A 2008 meta-analysis estimated clearance in the pediatric population by considering maturation of CL and body weight which showed a significant reduction compared to adults.<ref name="Robbie_2012" />

==Society and Culture== === Cost === Palivizumab is a relatively expensive medication, with a 100-mg vial ranging from $904 to $1866.<ref name="auto1">{{cite journal | vauthors = Mac S, Sumner A, Duchesne-Belanger S, Stirling R, Tunis M, Sander B | title = Cost-effectiveness of Palivizumab for Respiratory Syncytial Virus: A Systematic Review | journal = Pediatrics | volume = 143 | issue = 5 | article-number = e20184064 | date = May 2019 | pmid = 31040196 | doi = 10.1542/peds.2018-4064 | doi-access = free }}</ref> Multiple studies done by both the manufacturer and independent researchers to determine the cost-effectiveness of palivizumab have found conflicting results. The heterogeneity between these studies makes them difficult to compare. Given that there is no consensus about the cost-effectiveness of palivizumab, usage largely depends on the location of care and individual risk factors.<ref name="Andabaka_2013"/><ref name="Resch_2017"/><ref>{{cite journal | vauthors = Barr R, Green CA, Sande CJ, Drysdale SB | title = Respiratory syncytial virus: diagnosis, prevention and management | journal = Therapeutic Advances in Infectious Disease | volume = 6 | article-number = 2049936119865798 | date = 2019-07-29 | pmid = 31384456 | pmc = 6664627 | doi = 10.1177/2049936119865798 }}</ref>

A 2013 systematic review found a high level of variability in estimates of cost effectiveness for palivizumab prophylaxis. Some studies found that prophylaxis was a dominant strategy (meaning that it both provides clinical benefit and saves costs), up to an incremental cost-effectiveness ratio of $2,526,203 per quality-adjusted life-year (QALY).<ref name="auto1"/> It also showed an incremental cost-effectiveness ratio for preterm infants between $5188 and $791,265 per QALY, from the payer perspective.<ref name="auto1"/> However, as previously stated, the cost-effectiveness of palivizumab is undecided, and this meta-analysis is only one example of society can benefit from palivizumab prophylaxis.

== History == The disease burden of RSV in young infants and its global prevalence have prompted attempts for vaccine development. As of 2019, there was no approved vaccine for RSV prevention.<ref>{{cite book | vauthors = Shafique M, Zahoor MA, Arshad MI, Aslam B, Siddique AB, Rasool AH, Qamar MU, Usman M | chapter =Hurdles in Vaccine Development against Respiratory Syncytial Virus|date=2019-10-30| chapter-url=https://www.intechopen.com/books/the-burden-of-respiratory-syncytial-virus-infection-in-the-young/hurdles-in-vaccine-development-against-respiratory-syncytial-virus| title = The Burden of Respiratory Syncytial Virus Infection in the Young| veditors = Resch B |publisher=IntechOpen|language=en|doi=10.5772/intechopen.87126|isbn=978-1-78984-642-3|access-date=2021-08-03|doi-access=free}}</ref> A formalin-inactivated RSV vaccine (FIRSV) was studied in the 1960s. The immunized children who were exposed to the virus in the community developed an enhanced form of RSV disease presented by wheezing, fever, and bronchopneumonia. This enhanced form of the disease led to 80% hospitalization in the recipients of FIRSV compared to 5% in the control group. Additionally, 2 fatalities occurred among the vaccine recipients upon reinfection in subsequent years.<ref>{{cite journal | vauthors = Kim HW, Canchola JG, Brandt CD, Pyles G, Chanock RM, Jensen K, Parrott RH | title = Respiratory syncytial virus disease in infants despite prior administration of antigenic inactivated vaccine | journal = American Journal of Epidemiology | volume = 89 | issue = 4 | pages = 422–434 | date = April 1969 | pmid = 4305198 | doi = 10.1093/oxfordjournals.aje.a120955 }}</ref> Subsequent attempts to develop an attenuated live virus vaccine with optimal immune response and minimal reactogenicity have been unsuccessful.<ref name="pmid24362694">{{cite book | vauthors = Karron RA, Buchholz UJ, Collins PL | chapter = Live-Attenuated Respiratory Syncytial Virus Vaccines | series = Current Topics in Microbiology and Immunology | title = Challenges and Opportunities for Respiratory Syncytial Virus Vaccines | volume = 372 | pages = 259–284 | date = 2013 | pmid = 24362694 | pmc = 4794267 | doi = 10.1007/978-3-642-38919-1_13 | publisher = Springer Berlin Heidelberg | isbn = 978-3-642-38918-4 | veditors = Anderson L, Graham BS | place = Berlin, Heidelberg }}</ref> Further research on animal subjects suggested that intravenously administered immunoglobulin with high RSV neutralizing activity can protect against RSV infection.<ref>{{cite journal | vauthors = Boukhvalova MS, Yim KC, Blanco J | title = Cotton rat model for testing vaccines and antivirals against respiratory syncytial virus | journal = Antiviral Chemistry & Chemotherapy | volume = 26 | article-number = 2040206618770518 | date = 2018-01-01 | pmid = 29768937 | pmc = 5987903 | doi = 10.1177/2040206618770518 }}</ref> In 1995, the U.S. Food and Drug Administration (FDA) approved the use of RespiGam (RSV-IGIV) for the prevention of serious lower respiratory tract infection caused by RSV in children younger than 24 months of age with bronchopulmonary dysplasia or a history of premature birth.<ref>{{cite journal | vauthors = Pollack P, Groothuis JR | title = Development and use of palivizumab (Synagis): a passive immunoprophylactic agent for RSV | journal = Journal of Infection and Chemotherapy | volume = 8 | issue = 3 | pages = 201–206 | date = September 2002 | pmid = 12373481 | doi = 10.1007/s10156-002-0178-6 | s2cid = 39331984 }}</ref> The success of the RSV-IGIV demonstrated efficacy in immunoprophylaxis and prompted research into further technologies. Thus, Palivizumab was developed by AstraZeneca as a monoclonal antibody that was found to be fifty times more potent than its predecessor. This antibody has been widely used for RSV since 1998 when it was approved.<ref name = "Dessain_2021">{{Cite book |title=Human antibody therapeutics for viral disease|date=2021|publisher=Springer Verlag| vauthors = Dessain SK |isbn=978-3-540-72146-8|location=Berlin|oclc=209988317}}</ref>

Palivizumab, originally known as MEDI-493, was developed as an RSV immune prophylaxis tool that was easier to administer and more effective than the current tools of that time (the 1990s).<ref name = "Dessain_2021" /> It was developed over a 10-year period by MedImmune by combining human and mouse DNA.<ref>{{cite journal | vauthors = Johnson S, Oliver C, Prince GA, Hemming VG, Pfarr DS, Wang SC, Dormitzer M, O'Grady J, Koenig S, Tamura JK, Woods R, Bansal G, Couchenour D, Tsao E, Hall WC, Young JF | title = Development of a humanized monoclonal antibody (MEDI-493) with potent in vitro and in vivo activity against respiratory syncytial virus | journal = The Journal of Infectious Diseases | volume = 176 | issue = 5 | pages = 1215–1224 | date = November 1997 | pmid = 9359721 | doi = 10.1086/514115 | doi-access = free }}</ref> Specifically, antibody production was stimulated in a mouse model following immunization with RSV. The antibody-producing B cells were isolated from the mouse's spleen and fused with mouse myeloma cell lines. The antibodies were then humanized by cloning and sequencing the DNA from both the heavy and light chains of the monoclonal antibody. Overall, the monoclonal antibody is 95% similar to other human antibodies with the other 5% having DNA origins from the original mouse.<ref name="Resch_2017" />

== References == {{reflist}}

{{Monoclonals for infectious disease and toxins}} {{Immune sera and immunoglobulins}} {{AstraZeneca}} {{Portal bar | Medicine}}

Category:Monoclonal antibodies Category:Drugs developed by AbbVie Category:Drugs developed by AstraZeneca Category:Biotechnology Category:Respiratory syncytial virus