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Immunogenicity and Safety of the Adjuvanted Recombinant Zoster Vaccine in Chronically Immunosuppressed Adults Following Renal Transplant: A Phase 3, Randomized Clinical Trial.


ABSTRACT:

Background

The incidence of herpes zoster is up to 9 times higher in immunosuppressed solid organ transplant recipients than in the general population. We investigated the immunogenicity and safety of an adjuvanted recombinant zoster vaccine (RZV) in renal transplant (RT) recipients ≥18 years of age receiving daily immunosuppressive therapy.

Methods

In this phase 3, randomized (1:1), observer-blind, multicenter trial, RT recipients were enrolled and received 2 doses of RZV or placebo 1-2 months (M) apart 4-18M posttransplant. Anti-glycoprotein E (gE) antibody concentrations, gE-specific CD4 T-cell frequencies, and vaccine response rates were assessed at 1M post-dose 1, and 1M and 12M post-dose 2. Solicited and unsolicited adverse events (AEs) were recorded for 7 and 30 days after each dose, respectively. Solicited general symptoms and unsolicited AEs were also collected 7 days before first vaccination. Serious AEs (including biopsy-proven allograft rejections) and potential immune-mediated diseases (pIMDs) were recorded up to 12M post-dose 2.

Results

Two hundred sixty-four participants (RZV: 132; placebo: 132) were enrolled between March 2014 and April 2017. gE-specific humoral and cell-mediated immune responses were higher in RZV than placebo recipients across postvaccination time points and persisted above prevaccination baseline 12M post-dose 2. Local AEs were reported more frequently by RZV than placebo recipients. Overall occurrences of renal function changes, rejections, unsolicited AEs, serious AEs, and pIMDs were similar between groups.

Conclusions

RZV was immunogenic in chronically immunosuppressed RT recipients. Immunogenicity persisted through 12M postvaccination. No safety concerns arose.

Clinical trials registration

NCT02058589.

SUBMITTER: Vink P 

PROVIDER: S-EPMC6938982 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

Immunogenicity and Safety of the Adjuvanted Recombinant Zoster Vaccine in Chronically Immunosuppressed Adults Following Renal Transplant: A Phase 3, Randomized Clinical Trial.

Vink Peter P   Ramon Torrell Josep Maria JM   Sanchez Fructuoso Ana A   Kim Sung-Joo SJ   Kim Sang-Il SI   Zaltzman Jeff J   Ortiz Fernanda F   Campistol Plana Josep Maria JM   Fernandez Rodriguez Ana Maria AM   Rebollo Rodrigo Henar H   Campins Marti Magda M   Perez Rafael R   González Roncero Francisco Manuel FM   Kumar Deepali D   Chiang Yang-Jen YJ   Doucette Karen K   Pipeleers Lissa L   Agüera Morales Maria Luisa ML   Rodriguez-Ferrero Maria Luisa ML   Secchi Antonio A   McNeil Shelly A SA   Campora Laura L   Di Paolo Emmanuel E   El Idrissi Mohamed M   López-Fauqued Marta M   Salaun Bruno B   Heineman Thomas C TC   Oostvogels Lidia L  

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20200101 2


<h4>Background</h4>The incidence of herpes zoster is up to 9 times higher in immunosuppressed solid organ transplant recipients than in the general population. We investigated the immunogenicity and safety of an adjuvanted recombinant zoster vaccine (RZV) in renal transplant (RT) recipients ≥18 years of age receiving daily immunosuppressive therapy.<h4>Methods</h4>In this phase 3, randomized (1:1), observer-blind, multicenter trial, RT recipients were enrolled and received 2 doses of RZV or plac  ...[more]

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