Bispecific antibody Silevimig noninferior to rabies immunoglobulin in trial

A phase III randomized, double-blind, non-inferiority trial compared Silevimig, a bispecific anti-rabies monoclonal antibody, with human rabies immunoglobulin (HRIG) for post-exposure prophylaxis in 1,200 adults with WHO category III rabies exposure, given alongside standard vaccination. The trial reported that Silevimig met the non-inferiority criterion for day-7 rabies virus-neutralizing antibody concentrations (0.40 vs 0.36 IU/mL) and had slightly higher seroresponse rates at days 14 and 90, with no rabies cases in either group at one year and mostly mild to moderate adverse events. The trial's authors state these findings support Silevimig as a safe and effective alternative for passive rabies post-exposure prophylaxis.

Most relevant for: Adults with suspected WHO category III rabies exposure requiring post-exposure prophylaxis.

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