Viewing Study NCT03886038



Ignite Creation Date: 2024-05-06 @ 12:56 PM
Last Modification Date: 2024-10-26 @ 1:06 PM
Study NCT ID: NCT03886038
Status: COMPLETED
Last Update Posted: 2023-06-22
First Post: 2019-01-02

Brief Title: Subunit Vaccine Against Herpes Zoster in RA Patients Treated With JAK-inhibitors VACCIMIL-ZOSTER
Sponsor: Region Skane
Organization: Region Skane

Study Overview

Official Title: The Immunogenicity and Efficacy of Subunit Vaccine Against Herpes Zoster in RA Treated With JAK-inhibitors VACCIMIL-ZOSTER
Status: COMPLETED
Status Verified Date: 2023-06
Last Known Status: None
Delayed Posting: No
If Stopped, Why?: Not Stopped
Has Expanded Access: False
If Expanded Access, NCT#: N/A
Has Expanded Access, NCT# Status: N/A
Acronym: None
Brief Summary: Background A new subunit vaccine against herpes zoster HZ has recently been approved for vaccination of adults i in Sweden This vaccine Shingrix elicits a strong cellular and humoral immune response in healthy adults regardless of age Studies on the immunogenicity and efficacy of this vaccine in immunosuppressed patients such as patients with rheumatoid arthritis RA are scarce

Objectives To investigate 1 the immunogenicity of subunit vaccine against HZ in patients with RA treated with janus kinase JAK-inhibitors compared to healthy controls 2 the tolerability of subunit vaccine against HZ 3 long-term immunogenicity of two doses of subunit HZ vaccine 4 the impact of smoking habits and alcohol consumption on the immunogenicity of vaccine and protection against HZ 5 the efficacy of this vaccine

Methodology Patients with RA regularly followed at the Skåne University Hospital section for rheumatology in southern Sweden are eligible for the study and will be offered vaccination Blood samples will be collected immediately before the first vaccine dose and 4-6 weeks after the second dose and thereafter 3 and 5 years after the second vaccination The levels of antibodies to glycoprotein E gE will be measured with standard ELISA on the blood samples collected at vaccination 4-6 weeks following the second vaccination and after 3 and 5 years A flow-cytometric assay will be used for the detection of the cell-mediated immunity number of antigen specific CD4 T-cells against the varicella-zoster virus The prevalence of HZ among patients participating in the study will be compared to in-patient and out-patient registry data on the corresponding infections among age- and sex- matched non-vaccinated controls using data from the regional health and care registry in southern Sweden
Detailed Description: Background Treatment with JAK-inhibitors has been shown to improve the signs and symptoms of rheumatoid arthritis RA and delay the development of radiographic damage However these remedies have been shown to increase risk of herpes zoster HZ infections in RA Currently available live attenuated vaccine against HZ is contraindicated in patients receiving immunosuppressive treatments A new subunit vaccine against HZ has recently been approved for vaccination of adults in Sweden This vaccine Shingrix has been shown to elicit a strong cellular and humoral immune response in healthy adults regardless of age Studies on the immunogenicity and efficacy of this vaccine in immunosuppressed patients such as patients with RA are scarce

Objectives To investigate 1 the immunogenicity of 2 doses of HZ vaccine Shingrix administrated at least 2 months apart in patients with RA treated with JAK-inhibitors for at least 3 months compared to immunogenicity of the vaccine given to healthy controls 2 the tolerability of subunit vaccine against HZ ie whether vaccination is associated with increased disease activity flare of RA or the onset of other autoimmune disease 3 long-term immunogenicity of two doses of the subunit vaccine against HZ 4 the impact of smoking habits and alcohol consumption on the immunogenicity of vaccine and protection against HZ infection 5 the efficacy of the vaccine in preventing HZ

Methodology Patients with RA regularly followed at the Skåne University Hospital section for rheumatology already treated with JAK inhibitors for at least 3 months are eligible for the study and will be offered to participate in the study At vaccination the clinical examination is performed and data on disease and treatment characteristics co-morbidity smoking and alcohol habits are collected All participants are encouraged to take the notice of changes in the existing RA or other unexpected side effects following vaccinations Blood samples will be collected immediately before the first vaccination and 4-6 weeks after the second dose of the vaccine and thereafter 3 and 5 years after vaccination The levels of antibodies to glycoprotein E gE using standard ELISA will be performed on the blood samples collected at vaccination 4-6 weeks following the second dose of the vaccine and after 3 and 5 years A flow-cytometric assay will be used for the detection of the cell-mediated immunity number of antigen specific CD4 T-cells against the varicella-zoster virus The prevalence of HZ among patients participating in the study will be compared to in-patient and out-patient register data on the corresponding infections among age- and sex- matched non-vaccinated controls using data from the regional health and care registry in the Skåne region southern Sweden

Impact Results from this project will provide the evidence whether 2 doses of the subunit HZ vaccine is immunogenic safe and efficacious in patients with RA treated with JAK- inhibitors and which factors can influence the efficacy of the vaccine These results can be used for the future recommendations on vaccination against HZ and when in relation to treatment the immunization should be performed in order to reach the best protection In the long term this should result in decreased morbidity in HZ infections complication of those infections and lower health-care costs

Study Oversight

Has Oversight DMC: None
Is a FDA Regulated Drug?: False
Is a FDA Regulated Device?: False
Is an Unapproved Device?: None
Is a PPSD?: None
Is a US Export?: None
Is an FDA AA801 Violation?: None