乳児における重度の呼吸器同胞ウイルス関連下呼吸道感染症の予防のためのクレスロビマブの使用: 予防接種慣行に関する諮問委員会の勧告 - 2025年
MMWR. Morbidity and mortality weekly report
|August 29, 2025
まとめ
新しい勧告では,乳児の低呼吸道感染から保護するために,母親のワクチン接種と並行して,長時間作用する2つの単体抗体の選択肢,クレスロビマブとニルセビマブを提供しています.
科学分野:
- 小児科
- 免疫学
- 公衆衛生
背景:
- 呼吸器同胞性ウイルス (RSV) は歴史的にアメリカでは 乳児の入院を多く引き起こしています
- 現行のガイドラインでは,RSVに関連する下呼吸道感染症 (LRTI) に対する幼児の普遍的な保護を推奨しています.
- 保護は,長時間作用するモノクローン抗体の母体ワクチン接種または乳児投与によって達成されます.
研究 の 目的:
- 乳児のRSV予防におけるクレスロビマブの安全性と有効性を検討する.
- 乳児におけるクレスロビマブの使用に関する推奨事項を提示する.
- 乳児のRSV予防接種戦略に関するガイドラインを更新する.
主な方法:
- クレスロビマブの安全性と有効性に関する証拠のレビュー
- ニルセビマブの代替としてクレスロビマブの評価
- 主要予防方法として,母親のRSVワクチン接種を検討する.
主要な成果:
- 第2の長期作用のモノクローナル抗体は2025年6月に認可されました.
- ACIPは,母親のワクチン接種で保護されていない乳児に対して,ニルセビマブの代替としてクレスロビマブを推奨した.
- すべての乳児は,母体ワクチン,ニルセビマブ,またはクレスロビマブでRSV- LRTIの予防接種を受けるべきである.
結論:
- 乳児におけるRSV関連LRTIの予防には,クレスロビマブが追加的な選択肢である.
- 産薬の選択 (母親のワクチン接種,ニルセビマブ,またはクレスロビマブ) は,親の好み,利用可能性,およびRSVの季節に比べて出産のタイミングに依存します.
- 乳児におけるRSV- LRTIに対する普遍的な保護は極めて重要です.
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