At the 34th European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global (formerly ECCMID) conference in Barcelona, Spain, a year-long review highlighted publications from 2023–24 focusing on the prophylaxis and treatment of infectious diseases.
Following a near 60-year technological gap, two vaccines for the prevention of respiratory syncytial virus (RSV), Pfizer’s Abrysvo and GSK’s Arexvy, became licensed for use in elderly adults in 2023. Additionally, a Phase III, double-blind trial of Abrysvo conducted in 18 countries among pregnant women to prevent RSV illness in infants reported positive safety and efficacy data in 2023. Vaccine efficacy was calculated to be 81.8% in infants at age 90 days old, and 69.4% in infants at age 180 days old in medically attended severe RSV-associated lower respiratory tract illness. These findings presented a statistically significant difference between the vaccinated group and non-vaccinated placebo group. Additionally, no safety concerns were identified, which led to the licensing of the vaccine for pregnant women to protect infants and young children against RSV.
Furthermore, data was published in 2024 from a Phase III trial that analysed the efficacy and safety of Arexvy in older adults over two RSV seasons. The vaccine’s efficacy in adults who had received two RSV vaccinations over two RSV seasons was 67.1% for RSV and 78.8% for severe RSV. This was compared to 67.2% efficacy for RSV and 78.8% efficacy for severe RSV in adults who had received one dose of the vaccine, following two RSV seasons. While those who received two doses of the vaccine over two RSV seasons tolerated the doses well, it did not provide any additional efficacy benefit.
Another key study from 2023 regarding infectious disease prophylaxis focused on a 10-year follow-up of the nine-valent (9v) human papillomavirus (HPV) vaccine. The base study began in 2009 and included boys and girls ages 9–15 years who would be receiving three doses of the 9vHPV vaccine. These same individuals were eligible to participate in this study, which evaluated the immunogenicity, efficacy, and safety of the 9vHPV vaccine through month 126. The seropositivity rates of individuals at month 126 were 81–95%, depending upon the immunoassay, for each of the nine HPV vaccine strains. Additionally, there were no cases of HPV6/11/16/18/31/33/45/52/58-related high-grade intraepithelial neoplasia or condyloma in any of the study participants 10 years after administration of the third dose.
Regarding the treatment of infectious diseases, data was published in 2024 from two Phase III, randomised, multicenter, non-inferiority studies on the use of oral gepotidacin, a novel, first-in-class triazaacenaphthylene antibiotic, in patients with uncomplicated urinary tract infections: EAGLE-2 and EAGLE-3. In EAGLE-2, 50.6% of patients treated with gepotidacin reached therapeutic success, compared with 47.0% of patients treated with nitrofurantoin. In EAGLE-3, 58.5% of patients treated with gepotidacin reached therapeutic success, compared with 43.6% of patients treated with nitrofurantoin. Gepotidacin was found to be non-inferior to nitrofurantoin in both studies, and superior to nitrofurantoin in EAGLE-3, making it a safe and effective alternative for the treatment of uncomplicated urinary tract infections.
Similarly, data was published in 2024 supporting the use of the novel antibiotic, zosurabalpin, for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) infections. Zosurabalpin belongs to the novel class of tethered macrocyclic peptide antibiotics. It has exhibited in vitro activity and in vivo efficacy in treating drug-resistant contemporary isolates for CRAB in mouse infection models. Zosurbalpin is also promising as it is not expected to be affected by the pre-existing resistance mechanisms of Acinetobacter baumannii.
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