Raxibacumab for inhalational anthrax: an effective specific therapeutic approach?

Importance of the field: Inhalational anthrax is a disease with a high lethality potential and current therapeutic interventions with antibiotics to manage the bacteraemia might not always be fully effective. Blocking the activity of the toxins with raxibacumab, a fully-human mAb directed against the protective antigen of Bacillus anthracis, may serve as an adjunct treatment. The existing ones are aimed at preventing post-exposure bacteraemia but might not be always fully protective. Therefore, more specific 'therapies' are needed and the protective antigen of B. anthracis might be targeted effectively with raxibacumab, which is a blocking human mAb. Areas covered in this paper: To discuss the results of experimental and human studies evaluating raxibacumab for inhalational anthrax. What the reader will gain: Raxibacumab was efficacious prophylactically after exposure and therapeutically before exposure in rabbit and monkey animal models of inhalational anthrax and exhibited good safety and pharmacokinetic profiles in healthy humans. Take home message: Raxibacumab is a promising prophylactic and therapeutic for inhalational anthrax.