The Clinical Advantages of Anti-Rabies Monoclonal Antibodies in Post-Exposure Prophylaxis — Worldwide, 2016–2025

Post-exposure prophylaxis (PEP) represents the critical intervention for preventing rabies and comprises three essential components: thorough wound cleansing, vaccination, and administration of rabies immunoglobulin (RIG) or monoclonal antibodies (mAbs) for category III exposures. The World Health Organization (WHO) endorses the use of mAb cocktails as an effective replacement for RIG in PEP protocols. Since 2016, four anti-rabies monoclonal antibodies (RmAbs) have received clinical approval for use in India and China. This article provides an overview of the current research status of RmAb. By reviewing clinical studies related to RmAb, it highlights the clinical advantages of RmAb over HRIG in terms of efficacy, accessibility, safety, acceptability, and clinical application in special populations. Additionally, it explores the future clinical prospects of RmAb, including their use in extremely high-risk cases, their impact on circulating antibodies, and their potential role in rabies treatment.