Safety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxis

Abstract Rabies is one of the most lethal viral zoonoses, particularly in low- and middle-income countries where access to post-exposure prophylaxis is limited. Conventional post-exposure prophylaxis relies on rabies immune globulin and vaccination. This study evaluated the safety of a monoclonal an...

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Main Authors: Nidhi Fotedar, Haradanahalli Shankaraiah Ravish
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:npj Vaccines
Online Access:https://doi.org/10.1038/s41541-025-01109-w
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author Nidhi Fotedar
Haradanahalli Shankaraiah Ravish
author_facet Nidhi Fotedar
Haradanahalli Shankaraiah Ravish
author_sort Nidhi Fotedar
collection DOAJ
description Abstract Rabies is one of the most lethal viral zoonoses, particularly in low- and middle-income countries where access to post-exposure prophylaxis is limited. Conventional post-exposure prophylaxis relies on rabies immune globulin and vaccination. This study evaluated the safety of a monoclonal antibody cocktail, docaravimab and miromavimab, in 159 patients with severe animal bites. The cocktail was administered locally to 94.3 percent of participants and both locally and systemically to 5.7 percent. Adverse events were reported in 10.7 percent of cases, predominantly mild and local, with no systemic or severe reactions observed. No cases of rabies occurred during six months of follow-up. These findings suggest that the monoclonal antibody cocktail has a favorable safety profile, potentially serving as a viable alternative to traditional rabies immune globulin in post-exposure prophylaxis.
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spelling doaj-art-766a46e7513043adbb47ef1ac57762e82025-08-20T01:52:22ZengNature Portfolionpj Vaccines2059-01052025-05-011011710.1038/s41541-025-01109-wSafety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxisNidhi Fotedar0Haradanahalli Shankaraiah Ravish1Department of Community Medicine, Kempegowda Institute of Medical SciencesDepartment of Community Medicine, Kempegowda Institute of Medical SciencesAbstract Rabies is one of the most lethal viral zoonoses, particularly in low- and middle-income countries where access to post-exposure prophylaxis is limited. Conventional post-exposure prophylaxis relies on rabies immune globulin and vaccination. This study evaluated the safety of a monoclonal antibody cocktail, docaravimab and miromavimab, in 159 patients with severe animal bites. The cocktail was administered locally to 94.3 percent of participants and both locally and systemically to 5.7 percent. Adverse events were reported in 10.7 percent of cases, predominantly mild and local, with no systemic or severe reactions observed. No cases of rabies occurred during six months of follow-up. These findings suggest that the monoclonal antibody cocktail has a favorable safety profile, potentially serving as a viable alternative to traditional rabies immune globulin in post-exposure prophylaxis.https://doi.org/10.1038/s41541-025-01109-w
spellingShingle Nidhi Fotedar
Haradanahalli Shankaraiah Ravish
Safety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxis
npj Vaccines
title Safety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxis
title_full Safety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxis
title_fullStr Safety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxis
title_full_unstemmed Safety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxis
title_short Safety and tolerability of a novel monoclonal antibody cocktail for rabies post-exposure prophylaxis
title_sort safety and tolerability of a novel monoclonal antibody cocktail for rabies post exposure prophylaxis
url https://doi.org/10.1038/s41541-025-01109-w
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