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Long-term Immunogenicity of a Live Herpes Zoster Vaccine in Systemic Lupus Erythematosus (SLE) Patients

Completed
Conditions
Lupus Erythematosus
Interventions
Diagnostic Test: Immunogenicity
Registration Number
NCT04089930
Lead Sponsor
Tuen Mun Hospital
Brief Summary

A recent randomized controlled trial (RCT) from our group has demonstrated safety and immune response (both humoral and cell-mediated) of the live-attenuated herpes zoster (HZ) vaccine (Zostavax) in stable systemic lupus erythematosus (SLE) patients with a previous history of HZ or varicella infection. An important research question is whether the immunogenicity of the HZ vaccine in SLE patients is long-lasting. There is no information in the literature regarding the long-term immunogenicity and safety of Zostavax in SLE patients. This prompts the current extension study which is planned to evaluate the long-term immunogenicity and efficacy of Zostavax in our original patient cohort.

Detailed Description

A recent RCT from our group has demonstrated safety and immune response (both humoral and cell-mediated) of the live-attenuated Zostavax in stable SLE patients with a previous history of HZ or varicella infection. An important research question is whether the immunogenicity of the HZ vaccine in SLE patients is long-lasting. There is no information in the literature regarding the long-term immunogenicity and safety of the HZ vaccine, Zostavax, in SLE patients.

Patients who had completed the original RCT and had been followed for 5 years since HZ vaccination or placebo injection were invited to participate in this extension study. Blood samples will be taken for a repeat assessment of the humoral and cell-mediated response to VZV at 5 years.

Outcomes of interest Primary outcome Difference between the two groups in the proportion of patients who have a persistent and 50% increase in IgG to VZV (humoral response to Zostavax) at 5 years compared to baseline Secondary outcomes

1. Difference between the two groups in the cell-mediated response to Zostavax at 4 years as compared to baseline

2. Vaccine efficacy - difference in the rate of clinical HZ reactivation between two groups of patients at 5 years

3. Vaccine safety - difference between the two groups in terms of SLE flares and new autoimmune phenomena at 5 years

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
68
Inclusion Criteria
  1. SLE patients who fulfill ≥4 of the 1997 ACR or the 2012 SLICC/ACR criteria for SLE or healthy controls who had participated in the original RCT
  2. Age ≥18 years
  3. Having completed the original RCT of HZ vaccine vs placebo
  4. Having been followed for 5 years since HZ vaccination or placebo injection
  5. Willing to comply with all study procedures
Exclusion Criteria
  1. Patients who refuse to participate in this long-term extension study
  2. Patients in the placebo group who have subsequently received HZ vaccination
  3. Patients who cannot give a written consent (mentally incapable or illiterate)

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
VaccineImmunogenicityThose SLE patients who had been given herpes zoster vaccine in our original RCT
PlaceboImmunogenicityThose SLE patients who had been given placebo vaccination in our original RCT
Primary Outcome Measures
NameTimeMethod
Humoral immune response to vaccine5 years after vaccination

percentage and absolute change in anti-VZV IgG titer from baseline

Secondary Outcome Measures
NameTimeMethod
Cell-mediated immune response to vaccine5 years after vaccination

percentage and absolute change in VZV-stimulated T cell response (T cell spots) from baseline

Trial Locations

Locations (1)

Department of Medicine, Tuen Mun Hospital

🇨🇳

Hong Kong, China

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