title: Challenges and opportunities in developing respiratory syncytial virus therapeutics.
abstract: Two meetings, one sponsored by the Wellcome Trust in 2012 and the other by the Global Virology Foundation in 2013, assembled academic, public health and pharmaceutical industry experts to assess the challenges and opportunities for developing antivirals for the treatment of respiratory syncytial virus (RSV) infections. The practicalities of clinical trials and establishing reliable outcome measures in different target groups were discussed in the context of the regulatory pathways that could accelerate the translation of promising compounds into licensed agents. RSV drug development is hampered by the perceptions of a relatively small and fragmented market that may discourage major pharmaceutical company investment. Conversely, the public health need is far too large for RSV to be designated an orphan or neglected disease. Recent advances in understanding RSV epidemiology, improved point-of-care diagnostics, and identification of candidate antiviral drugs argue that the major obstacles to drug development can and will be overcome. Further progress will depend on studies of disease pathogenesis and knowledge provided from controlled clinical trials of these new therapeutic agents. The use of combinations of inhibitors that have different mechanisms of action may be necessary to increase antiviral potency and reduce the risk of resistance emergence.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, and Colorado School of Public Health, Aurora.
authors.forename: Eric A F
authors.initials: EA
authors.lastname: Simões
authors.affiliation: Department of Pediatrics, Division of Infectious Diseases, and Department of Microbiology, Immunology and Biochemistry, University of Tennessee School of Medicine Children's Foundation Research Institute at Le Bonheur Children's Hospital, Memphis.
authors.forename: John P
authors.initials: JP
authors.lastname: DeVincenzo
authors.affiliation: Fred Hutchinson Cancer Research Center and University of Washington, Seattle.
authors.forename: Michael
authors.initials: M
authors.lastname: Boeckh
authors.affiliation: Department of Pediatrics and Laboratory of Translational Immunology, University Medical Center Utrecht, The Netherlands.
authors.forename: Louis
authors.initials: L
authors.lastname: Bont
authors.affiliation: Department of Pediatrics and the Vanderbilt Vaccine Center, Vanderbilt University, Nashville, Tennessee.
authors.forename: James E
authors.initials: JE
authors.lastname: Crowe
authors.affiliation: Centre for Virology, University College London Medical School.
authors.forename: Paul
authors.initials: P
authors.lastname: Griffiths
authors.affiliation: Department of Medicine, University of Virginia School of Medicine, Charlottesville.
authors.forename: Frederick G
authors.initials: FG
authors.lastname: Hayden
authors.affiliation: Clinical Virology Laboratory, Children's Hospital of Philadelphia, Pennsylvania.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Hodinka
authors.affiliation: Department of Pediatrics, University College London Institute of Child Health.
authors.forename: Rosalind L
authors.initials: RL
authors.lastname: Smyth
authors.affiliation: Wellcome Trust, Innovations, London.
authors.forename: Keith
authors.initials: K
authors.lastname: Spencer
authors.affiliation: NDA Advisory Services Ltd, Leatherhead, United Kingdom Department of Health Sciences, University of Copenhagen, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Thirstrup
authors.affiliation: Department of Medicine, Infectious Diseases Unit, Rochester General Hospital, New York.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Walsh
authors.affiliation: Department of Pediatrics, Microbiology, Medicine and Neurosurgery, University of Alabama at Birmingham.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Whitley
mesh_terms: D000998:Antiviral Agents / Q000302:isolation & purification* / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D017277:Drug Approval; D055808:Drug Discovery; D004359:Drug Therapy, Combination / Q000379:methods; D006801:Humans; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D012136:Respiratory Syncytial Viruses / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents
keywords: patient populations; respiratory syncytial virus; therapeutic strategies