Please compare and contrast clesrovimab and nirsevimab. Please include national guideline recommendations and clinical trials.

Comment by InpharmD Researcher

Direct clinical evidence comparing nirsevimab and clesrovimab are lacking, as data are primarily limited to placebo-controlled trials. According to guidelines, nirsevimab and clesrovimab are both first-line agents for RSV immunization of infants entering their first RSV season and no preference for either agent is noted. Pivotal studies for each agent are outlined in Tables 1 to 4.

Background

Beginning in August 2023, the United States Center for Disease Control (CDC) Advisory Committee on Immunization Practices (ACIP) recommended RSV monoclonal antibody immunization for all infants aged <8 months who are born during or entering their first RSV season and for infants and children aged 8-19 months who are at increased risk for severe RSV disease and are entering their second RSV season. At the time, nirsevimab was the only long-acting RSV-targeted monoclonal antibody available. In September of 2023, active maternal vaccination (with Abrysvo®) for RSV was added as another option to prevent RSV-associated lower respiratory tract infection in infants. Updated ACIP recommendations published in August 2025 expanded the previous recommendation to include clesrovimab as one of two options for immunization of infants less than 8 months old entering their first RSV season only (nirsevimab or clesrovimab). No specific RSV antibody agent is considered preferred for this population. Those born between October 1-March 31 should receive the RSV antibody dose within 1 week after birth, ideally during the birth hospitalization. Infants born outside of RSV season should receive the RSV antibody at the earliest opportunity, beginning in October. Timing may vary based on geographic area. Providers may consider administering RSV antibody to eligible hospitalized infants during their hospitalization, based on clinical judgment. ACIP immunization schedules have not yet been updated to include clesrovimab; however, schedules generally mirror the recommendations above. It is also noted that nirsevimab can be administered to children who are eligible to receive palivizumab, in place of palivizumab. [1], [2], [3], [4]

As of August 2025, the American Academy of Pediatrics (AAP) recommends RSV immunization for infants <8 months of age who are born during or entering their first RSV season (if their pregnant parent did not receive RSV vaccination during this pregnancy or other special circumstances). Nirsevimab and clesrovimab are both first-line agents for RSV immunization of infants entering their first RSV season; no preference for agent is noted. RSV immunization is also recommended for infants and children 8-19 months of age that are at high risk of severe RSV disease and entering their second RSV season. Only nirsevimab is indicated for immunization of high-risk patients entering their second RSV season. High risk includes: children with chronic lung disease of prematurity who required medical support (chronic corticosteroid therapy, diuretic therapy, or supplemental oxygen) at any time during the 6-month period before the start of the second RSV season, children with severe immunocompromise, children with cystic fibrosis who have either manifestations of severe lung disease (previous hospitalization for pulmonary exacerbation in the first year of life or abnormalities on chest imaging that persist when stable), or weight-for-length that is less than the 10th percentile, and American Indian or Alaska Native children. Immunization is not needed for most infants <8 months of age whose pregnant parent received RSV vaccination during the pregnancy and ≥14 days before giving birth. RSV immunization may be considered for infants born to a vaccinated pregnant parent in rare circumstances when, based on the clinical judgment of the health care provider, the potential incremental benefit of administration is warranted. Palivizumab is no longer routinely recommended for use and will be discontinued as of December 31, 2025. [5]

A 2026 bayesian network meta-analysis indirectly compared nirsevimab with palivizumab using placebo as the common comparator in three randomized trials involving 2,464 otherwise healthy infants born at 29 to 35 weeks’ gestation. Palivizumab reduced medically attended, nonhospitalized RSV infection by 70.5% versus placebo, with event rates of 2.8% versus 9.5% and a palivizumab-to-placebo median rate ratio of 1:3.43 (95% credible interval, 1.75-6.17). When the palivizumab and nirsevimab placebo-relative effects were compared, the difference between their median rate ratios was 0.27 (95% credible interval, −2.20 to 2.37), indicating no statistically detectable efficacy difference. Their reported efficacy against RSV hospitalization was also nearly identical—78.0% for palivizumab and 78.4% for nirsevimab. These findings suggest broadly comparable efficacy, but the comparison was indirect rather than head-to-head and depended on assumptions connecting hospitalization and nonhospitalized infection outcomes across trials with differing definitions and follow-up periods. [6]

In a 2025 meta-analysis, among 7,347 preterm infants, nirsevimab was substantially more effective than placebo or no immunization in preventing the principal RSV outcomes. Across four studies involving 1,725 infants, nirsevimab reduced the odds of medically attended RSV-associated LRTI by 75% (OR, 0.25; 95% CI, 0.15-0.40; P<.0001; I²=0%). The randomized-trial-only analysis produced the same estimate (OR, 0.25; 95% CI, 0.15-0.40), indicating that the result was not driven by observational data. Across four studies involving 7,075 infants, nirsevimab reduced RSV-LRTI hospitalization by 73% (OR, 0.27; 95% CI, 0.19-0.38; P<.0001; I²=0%). Thus, efficacy was similar for preventing medically attended disease and hospitalization, with consistently low statistical heterogeneity. The analysis was limited by insufficient data for comparisons by gestational age, birth weight, or other clinical outcomes. Notably, the main text reports seven included studies, whereas the abstract reports five. [7]

Across 26 randomized and observational studies comprising 425,362 infants in another 2025 meta-analysis, nirsevimab was more effective than placebo or no immunization in preventing RSV morbidity. It reduced RSV-related lower respiratory tract infection (LRTI) by 63% overall (RR, 0.37; 95% CI, 0.29-0.47); the reduction was 74% in randomized trials (RR, 0.26; 95% CI, 0.20-0.35) versus 59% in observational studies (RR, 0.41; 95% CI, 0.31-0.54). RSV-related hospitalization decreased by 73% overall (RR, 0.27; 95% CI, 0.20-0.37), including reductions of 78% in randomized trials (RR, 0.22; 95% CI, 0.15-0.33) and 71% in observational studies (RR, 0.29; 95% CI, 0.20-0.40). Nirsevimab also reduced intensive care unit admission (RR, 0.34; 95% CI, 0.20-0.58), emergency visits (RR, 0.33; 95% CI, 0.25-0.43), and bronchiolitis (RR, 0.48; 95% CI, 0.40-0.57), but did not significantly reduce mechanical ventilation (RR, 0.89; 95% CI, 0.73-1.09). Reconstructed time-to-event analyses further favored nirsevimab for RSV-LRTI (HR, 0.25; 95% CI, 0.16-0.37) and RSV hospitalization (HR, 0.14; 95% CI, 0.08-0.25). The randomized comparisons were consistent with no heterogeneity, whereas pooled observational estimates had substantial heterogeneity. [8]

Literature Review

A search of the published medical literature revealed 5 studies investigating the researchable question:

Please compare and contrast clesrovimab and nirsevimab. Please include national guideline recommendations and clinical trials.

Level of evidence

C - Multiple studies with limitations or conflicting results Read more→

Please see Tables 1-5 for your response.

Clesrovimab in Infants at Increased Risk For Severe Disease During 2 RSV Seasons
Design	Randomized, partially masked, palivizumab-controlled, phase 3 clinical trial N= 997
Objective	To evaluate the safety and tolerability of clesrovimab (105 mg) vs palivizumab in RSV season 1 in infants at increased risk for severe RSV disease. Key secondary objectives include describing the safety of 210 mg of clesrovimab in RSV season 2 in children who remain at increased risk for severe RSV disease, clesrovimab pharmacokinetics, and the incidence of RSV-associated disease.
Study Groups	Clesrovimab 105 mg (n= 498) Palivizumab (n= 499) Clesrovimab 210 mg in season 2 (n= 276)
Inclusion Criteria	Palivizumab-eligible infants, including those with prematurity, chronic lung disease of prematurity, or hemodynamically significant congenital heart disease. Early or Moderate Preterm Group (excluding participants with CLD or hemodynamically significant CHD): ≤35 weeks, 0 days gestational age CLD/CHD Group: CLD Participants: had CLD of prematurity (also known as bronchopulmonary dysplasia), as defined by: ≤32 weeks, 0 days gestational age and require medical intervention/management (i.e., supplemental oxygen, bronchodilators, or chronic systemic corticosteroids) for at least 28 days after birth, or o Other national or local guidelines or professional society recommendations
Exclusion Criteria	Severe immunodeficiency or previous receipt of any vaccine (including maternal vaccination) or mAb for the prevention of RSV
Methods	Participants, randomized 1:1 and stratified by region and condition, received clesrovimab (105 mg) on day 1 followed by placebo on day 28 or monthly palivizumab (15 mg/kg) up to 5 doses (1 dose per month). Eligible infants received open-label clesrovimab (210 mg) before their second RSV season
Duration	November 30, 2021, to November 20, 2025
Outcome Measures	Primary: Proportions of participants experiencing adverse events (AEs) after clesrovimab or palivizumab in season 1 Secondary: Safety of 210 mg of clesrovimab in season 2, clesrovimab pharmacokinetics, incidence of RSV-associated disease
Baseline Characteristics		Clesrovimab (n = 498)	Palivizumab (n = 499)
	Sex - Male	252 (50.6%)	248 (49.7%)
	Sex - Female	246 (49.4%)	251 (50.3%)
	Age <6 months	455 (91.4%)	429 (86.0%)
	Gestational age <29 weeks	123 (24.7%)	132 (26.5%)
	Gestational age ≥29 to <35 weeks	323 (64.9%)	314 (62.9%)
	Body weight, kg - Mean (SD)	3.7 (1.4)	3.7 (1.5)
Results	RSV-associated disease end point (150 days after injection)	Clesrovimab (n = 498)	Palivizumab (n = 499)
	Severe MALRI	0.8% (95% CI, 0.2%-2.1%)	1.5% (95% CI, 0.6%-3.0%)
	Hospitalization for LRI	1.0% (95% CI, 0.3%-2.4%)	1.7% (95% CI, 0.7%-3.3%)
	MALRI requiring ≥1 indicators of LRI or severity	3.2% (95% CI, 1.8%-5.2%)	3.4% (95% CI, 2.0%-5.6%)
	The peak geometric mean clesrovimab serum concentration at day 7 was 148.7μg/mL after a 105 mg dose in season 1 and was 170.0μg/mL after a 210-mg dose in season 2. The geometric mean clesrovimab serum concentration at day 150 was 11.8μg/mL in season 1 and was 14.4μg/mL in season 2. Anti-drug antibodies developed in 19 of 388 infants (4.9%) at day 150 in season 1 and in 25 of 233 children (10.7%; 12 of whom received clesrovimab in season 1) at day 150 in season 2.
Adverse Events	The proportions of participants experiencing adverse events were comparable between treatment groups in season 1. In season 2, clesrovimab, 210 mg was well tolerated. Solicited injection-site AEs were observed among 6.5% of children receiving a 210-mg dose in season 2, with injection-site pain being the most common. Anaphylaxis or hypersensitivity AESIs were not reported in either season
Study Author Conclusions	Clesrovimab was well tolerated in infants at increased risk for severe RSV disease through 2 RSV seasons. These findings support the use of clesrovimab in children who remain at risk for severe RSV disease in their second RSV season.
Critique	The study was robust in its design, being a large, multicenter, randomized controlled trial, which strengthens the reliability of the findings. However, the lack of a comparator arm in season 2 limits the ability to directly compare the efficacy of clesrovimab in the second season. Additionally, the study was not powered to assess noninferiority compared to palivizumab, and the results should be interpreted with caution due to the lack of adjustment for multiplicity in safety comparisons.

Table 1 References:
[9] Zar HJ, Bont LJ, Manzoni P, Muoz FM, Ramilo O, Chen PY, Novoa JM, Ordoez GA, Tsolia M, Tapiro B, Acua-vila MI, Castellanos JM, Meyer M, Morioka I, Heinonen S, Chen Z, Zeng T, Railkar RA, Arriola CS, Zang X, Hildebrand C, Maestri A, Castagnini LA, Sinha A; SMART (MK-1654-007) study group. Clesrovimab in Infants at Increased Risk For Severe Disease During 2 RSV Seasons: A Randomized Clinical Trial. JAMA Pediatr. 2026 Jul 20:e262760. doi:10.1001/jamapediatrics.2026.2760

Clesrovimab for Prevention of RSV Disease in Healthy Infants
Design	Double-blind, randomized, placebo-controlled trial N= 3614
Objective	To evaluate the efficacy and safety of one 105-mg dose of clesrovimab in healthy preterm and full-term infants entering their first RSV season
Study Groups	Clesrovimab (n= 2412) Placebo (n= 1202)
Inclusion Criteria	Healthy infants under the chronologic age of 1 year, born either early or moderately preterm (gestational age, 29 weeks to 34 weeks 6 days) or late preterm or full-term (gestational age, ≥35 weeks)
Exclusion Criteria	Recommendation to receive palivizumab, recent history of febrile illness, any previous preventive RSV treatment
Methods	Infants were randomly assigned in a 2:1 ratio to receive a 105-mg intramuscular injection of clesrovimab or placebo. Surveillance for respiratory infection was conducted during RSV season 1 (through day 180 after injection) and season 2 (days 365 to 515).
Duration	Surveillance through day 180 after injection for efficacy; safety follow-up through at least 240 days after injection
Outcome Measures	Primary: RSV-associated medically attended lower respiratory infection through 150 days Secondary: RSV-associated hospitalization through 150 days, safety and adverse events
Baseline Characteristics		Clesrovimab (N=2411)	Placebo (N=1203)	Total (N=3614)
	Male	1228 (50.9%)	617 (51.3%)	1845 (51.1%)
	Age - Mean, months	3.7±2.6	3.7±2.6	3.7±2.6
	Age - <6 mo	1923 (79.8%)	964 (80.1%)	2887 (79.9%)
	Age - 6 to <9 mo	383 (15.9%)	192 (16.0%)	575 (15.9%)
	Age - ≥9 mo	105 (4.4%)	47 (3.9%)	152 (4.2%)
	Gestational age - ≥29 to <35 wk	422 (17.5%)	209 (17.4%)	631 (17.5%)
	Gestational age - ≥35 wk	1989 (82.5%)	994 (82.6%)	2983 (82.5%)
	Body weight, kg	5.8±2.0	5.9±2.0	5.8±2.0
	Body length, cm	59.2±7.6	59.3±7.5	59.2±7.5
Results		Clesrovimab (n=2398)	Placebo (n=1201)	Efficacy (95% CI)
	RSV-associated medically attended LRI	60 (2.6%)	74 (6.5%)	60.4% (44.1 to 71.9)
	RSV-associated hospitalization	9 (0.4%)	28 (2.3%)	84.2% (66.6 to 92.6)
	Severe medically attended LRI	2 (0.1%)	12 (1.0%)	91.7% (62.9 to 98.1)
	Hospitalization for LRI	5 (0.2%)	23 (1.9%)	81.3% (62.5 to 90.7)
	Acute respiratory infection	148 (6.2%)	154 (12.8%)	50.0% (37.4 to 60.1)
Adverse Events	Serious adverse events were reported in 11.5% of infants in the clesrovimab group and 12.4% in the placebo group. Common adverse events included injection-site pain and irritability. One serious adverse event related to clesrovimab was a grade 3 event of urticaria, which resolved after 4 days.
Study Author Conclusions	A single dose of clesrovimab reduced the incidence of RSV-associated medically attended lower respiratory infection and RSV-associated hospitalization in healthy preterm and full-term infants, with a safety profile similar to that of placebo.
Critique	The study was robust with a large sample size and demonstrated significant efficacy of clesrovimab in preventing RSV-associated infections. However, the exclusion of infants eligible for palivizumab may limit the generalizability of the findings to all high-risk infant populations. Additionally, the trial's reliance on a single RSV season may not capture long-term safety and efficacy outcomes.

Table 2 References:
[10] Zar HJ, Simes EAF, Madhi SA, et al. Clesrovimab for Prevention of RSV Disease in Healthy Infants. N Engl J Med. 2025;393(13):1292-1303. doi:10.1056/NEJMoa2502984

Nirsevimab for Prevention of Hospitalizations Due to RSV in Infants
Design	Pragmatic, open-label, two-group, randomized trial N= 8058
Objective	To assess the efficacy and safety of nirsevimab in preventing hospitalizations for RSV-associated lower respiratory tract infection in infants under real-world conditions
Study Groups	Nirsevimab (n= 4037) Standard care (n= 4021)
Inclusion Criteria	Healthy infants 12 months of age or younger, born at a gestational age of at least 29 weeks, entering their first RSV season in France, Germany, or the United Kingdom
Exclusion Criteria	Eligibility to receive palivizumab
Methods	Infants were randomly assigned to receive a single intramuscular injection of nirsevimab (50 mg for infants <5 kg and 100 mg for those ≥5 kg) or standard care. Monitoring was done remotely through electronic diaries and digital health records. RSV testing was performed as part of routine practice for hospitalized infants.
Duration	August 8, 2022, to February 28, 2023
Outcome Measures	Primary: Hospitalization for RSV-associated lower respiratory tract infection Secondary: Very severe RSV-associated lower respiratory tract infection
Baseline Characteristics		Nirsevimab (N= 4037)	Standard Care (N= 4021)
	Age, mean months	4.53±3.34	4.48±3.30
	Male	2087 (51.7%)	2108 (52.4%)
	Gestational age at birth, mean weeks	38.84±2.28	38.93±5.35
	Weight, mean kg	5.97±2.30	5.92±2.27
Results		Nirsevimab (n= 4037)	Standard Care (n= 4021)	p-value
	Hospitalization for RSV-associated lower respiratory tract infection	11 (0.3%)	60 (1.5%)	<0.001
	Very severe RSV-associated lower respiratory tract infection	5 (0.1%)	19 (0.5%)	0.004
	Corresponding nirsevimab efficacy of 83.2% (95% confidence interval [CI], 67.8 to 92.0; p< 0.001)
Adverse Events	Treatment-related adverse events occurred in 86 infants (2.1%) in the nirsevimab group
Study Author Conclusions	Nirsevimab protected infants against hospitalization for RSV-associated lower respiratory tract infection and very severe RSV-associated lower respiratory tract infection under real-world conditions
Critique	The study's pragmatic design and large sample size enhance its applicability to real-world settings. However, the open-label design may introduce bias, and the short duration of efficacy assessment limits long-term conclusions. The study did not include blinding, which could affect health care-seeking behavior.

Table 3 References:
[11] Drysdale SB, Cathie K, Flamein F, et al. Nirsevimab for Prevention of Hospitalizations Due to RSV in Infants. N Engl J Med. 2023;389(26):2425-2435. doi:10.1056/NEJMoa2309189

Nirsevimab for Prevention of RSV in Healthy Late-Preterm and Term Infants
Design	Phase 3, randomized, double-blind, placebo-controlled trial N= 1490
Objective	To evaluate the efficacy and safety of nirsevimab in preventing medically attended RSV-associated lower respiratory tract infection in healthy late-preterm and term infants
Study Groups	Nirsevimab group (n= 994) Placebo group (n= 496)
Inclusion Criteria	Healthy infants born at a gestational age of at least 35 weeks, 1 year of age or younger, entering their first RSV season
Exclusion Criteria	Infants meeting criteria for commercial palivizumab, fever or acute illness within 7 days before randomization, or RSV infection before or at randomization
Methods	Infants were randomly assigned in a 2:1 ratio to receive a single intramuscular injection of nirsevimab (50 mg if <5 kg or 100 mg if ≥5 kg) or placebo before the RSV season. A sample size of approximately 1500 participants would give the trial at least 99% power to detect a 70% lower relative risk of a primary end-point event with nirsevimab than with placebo, at a two-sided significance level of 0.05, under the assumption of an 8% incidence of medically attended RSV-associated lower respiratory tract infection among participants in the placebo group.
Duration	Follow-up through 150 days after injection, with additional data collected up to 361 days
Outcome Measures	Primary: Medically attended RSV-associated lower respiratory tract infection Secondary: Hospitalization for RSV-associated lower respiratory tract infection
Baseline Characteristics		Nirsevimab (N= 994)	Placebo (N= 496)
	Age ≤3.0 mo	577 (58.0%)	285 (57.5%)
	Age >3.0 to ≤6.0 mo	317 (31.9%)	162 (32.7%)
	Age >6.0 mo	100 (10.1%)	49 (9.9%)
	Gestational age ≥35 to <37 wk	132 (13.3%)	76 (15.4%)
	Gestational age ≥37 wk	861 (86.7%)	419 (84.6%)
	Female sex	464 (46.8%)	257 (51.8%)
	Weight <5 kg	403 (40.6%)	192 (38.7%)
	Weight ≥5 kg	589 (59.4%)	304 (61.3%)
	Race - White	524 (52.9%)	272 (54.8%)
	Race - Black	286 (28.9%)	136 (27.4%)
Results		Nirsevimab (N= 994)	Placebo (N= 496)	Efficacy (95% CI)	P Value
	Medically attended RSV-associated lower respiratory tract infection	12 (1.2%)	25 (5.0%)	74.5% (49.6 to 87.1)	<0.001
	Hospitalization for RSV-associated lower respiratory tract infection	6 (0.6%)	8 (1.6%)	62.1% (-8.6 to 86.8)	0.07
Adverse Events	Serious adverse events were reported in 6.8% of nirsevimab recipients and 7.3% of placebo recipients. No serious hypersensitivity reactions were reported. One nirsevimab recipient had a grade 3 generalized macular rash, which resolved without treatment.
Study Author Conclusions	A single injection of nirsevimab administered before the RSV season protected healthy late-preterm and term infants from medically attended RSV-associated lower respiratory tract infection.
Critique	The study demonstrated significant efficacy of nirsevimab in preventing RSV-associated infections with a favorable safety profile. However, the trial was affected by the COVID-19 pandemic, which may have influenced RSV transmission rates and the power to evaluate hospitalizations. The study's generalizability may be limited by the specific population and settings involved.

Table 4 References:
[12] Hammitt LL, Dagan R, Yuan Y, et al. Nirsevimab for Prevention of RSV in Healthy Late-Preterm and Term Infants. N Engl J Med. 2022;386(9):837-846. doi:10.1056/NEJMoa2110275

Cost‑Effectiveness of Nirsevimab and Clesrovimab in Preventing Respiratory Syncytial Virus Lower Respiratory Tract Disease in Infants in the United States: A Modeling Study
Design	Modeling study using a cost-effectiveness analysis framework
Objective	To evaluate the cost-effectiveness of nirsevimab and clesrovimab in preventing RSV-related lower respiratory tract disease in infants in the United States
Inclusion Criteria	Infants in the United States, born outside and during the RSV season
Methods	A cost-effectiveness analysis framework was developed to perform an indirect comparison of nirsevimab and clesrovimab. Pharmacokinetic data were used to model the duration of cumulative efficacy over time. A 150-day duration was evaluated for nirsevimab, while three scenarios were assessed for clesrovimab (100-, 120-, and 150-day durations). A cost–utility analysis evaluated health outcomes, healthcare resource use, and associated costs
Outcome Measures	Primary: Incremental cost–utility of nirsevimab and clesrovimab Secondary: Reduction in RSV medically attended lower respiratory tract diseases, healthcare resource utilization, and total costs
Results		Nirsevimab	Clesrovimab (100 days)	Clesrovimab (120 days)	Clesrovimab (150 days)
	Total RSV MA cases prevented	364,204	173,276	213,427	261,358
	Hospitalizations prevented	32,404	23,957	27,126	30,483
	ER visits prevented	88,647	38,578	49,008	61,478
	PC visits prevented	243,103	110,719	137,265	169,362
	Deaths prevented	50	23	28	34
	Total costs (incremental)	$2,883,911	$380,334,486	$265,981,361	$142,353,070
	ICER ($/QALY saved)	$411	$113,148	$64,510	$28,237
	Nirsevimab consistently provided greater clinical benefit and more favorable economic outcomes compared to clesrovimab across all evaluated scenarios. Compared to the pre-2023 palivizumab-only standard of care, nirsevimab reduced RSV MA LRTD cases by approximately 70%, including a 73% reduction in hospitalizations and a 69% decrease in emergency room visits, while decreasing direct inpatient costs by over 70%. Clesrovimab reduced these outcomes between 33–50% for medically attended cases and 54–69% for hospitalizations depending on the assumed duration of efficacy, with associated direct cost savings between 55–67%. Direct head-to-head model comparisons revealed that nirsevimab averted up to 190,928 additional RSV MA cases and achieved 7,017 quality-adjusted life year (QALYs) gained compared to clesrovimab, which showed higher incremental costs and fewer QALYs saved, resulting in clesrovimab being dominated (more costly and less effective) in all scenarios.
Study Author Conclusions	Nirsevimab is economically dominant over clesrovimab, providing greater clinical protection against RSV-related disease. These results are robust to sensitivity analyses, with nirsevimab consistently reducing healthcare resource utilization and total costs compared to clesrovimab.
Critique	The study provides a comprehensive cost-effectiveness analysis using a modeling approach, which is a strength. However, the lack of direct head-to-head clinical trial data between nirsevimab and clesrovimab is a limitation, as the analysis relies on indirect comparisons and assumptions about pharmacokinetic profiles and efficacy durations. Additionally, the study does not account for real-world evidence for clesrovimab, which could impact the generalizability of the findings.

Table 5 References:
[13] Yarnoff B, Beuvelet M, Soudani S, Neary MP, Hodges EN, Chit A, Tribaldos M, Gabriel V, Musci R, Geurtsen J, Krilov LR. Cost-Effectiveness of Nirsevimab and Clesrovimab in Preventing Respiratory Syncytial Virus Lower Respiratory Tract Disease in Infants in the United States: A Modeling Study. Infect Dis Ther. 2026 Apr;15(4):1047-1073. doi:10.1007/s40121-026-01311-w