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Arexvy is a recombinant subunit vaccine developed by GSK to prevent lower respiratory tract disease (LRTD) caused by respiratory syncytial virus (RSV) in adults aged 60 years and older. It consists of a stabilized pre-fusion conformation of the RSV F protein (RSVPreF3) combined with GSK's proprietary AS01E adjuvant system. The AS01E adjuvant, which contains 3-O-desacyl-4'-monophosphoryl lipid A (MPL) and QS-21 in a liposomal formulation, is designed to enhance the T-cell and antibody response to the antigen. By targeting the pre-fusion state of the F protein—the primary target for neutralizing antibodies—the vaccine elicits a robust immune response against both RSV-A and RSV-B subtypes. It was the first RSV vaccine to receive regulatory approval globally.
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