A Pilot Study Evaluating Immunogenicity of Herpes Zoster Subunit Vaccine in Inflammatory Bowel Disease Patients Treated With Vedolizumab
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 33
- 试验地点
- 1
- 主要终点
- Change in Cell Mediated Immunity
研究概览
简要总结
Inflammatory bowel disease (IBD) is a chronic inflammatory state of the gastrointestinal tract(1) affecting 1.6-3.1 million people in the United States. Patients with IBD are treated with immunosuppressants that increase their risk of herpes zoster (HZ), also known as shingles.
Those with IBD have a two-fold increased risk for HZ compared to age matched controls. Because most IBD patients are treated with systemic immunosuppressants, which are an independent risk factor for HZ, the live attenuated HZ vaccine was not recommended. However, the release of the new inactivated HZ vaccine, Shingrix (GlaxoSmithKline), presents new opportunities for preventive care.
详细描述
The purpose of this study is to determine the immunogenicity of the herpes zoster subunit vaccine in inflammatory bowel disease patients on vedolizumab compared to those on anti-tumor necrosis factor (TNF) monotherapy.
The study will evaluate humoral and cell mediated immunity in patients with IBD on vedolizumab who receive the two-dose herpes zoster vaccine. The investigators will evaluate short term, one month after second vaccination dose and sustained immunogenicity at 6 and 12 months post vaccination.
The central hypothesis of this proposal is that IBD patients on vedolizumab should be able to mount a normal vaccine response comparable to those on anti-TNF monotherapy who might benefit from a third dose of the subunit vaccine as has been evaluated in HIV and transplant populations. The hypothesis is that IBD patients on vedolizumab will be able to mount a superior response to those on anti-TNF therapy. A recent study showed that hepatitis B vaccine immunogenicity was not affected by vedolizumab.
The study population will include adult patients aged 50 or older with IBD(diagnosed by standard clinical, radiographic, endoscopic, and histopathologic criteria) receiving care at University of Wisconsin Hospital and Clinics or Boston Medical Center. There is no randomization or use of placebo in this study. Two study groups (each containing 15 subjects) will be established Group A: Patients with IBD on anti-TNF monotherapy and Group B patients with IBD on vedolizumab monotherapy.
Methods: Eligible patients with IBD will be recruited from the University of Wisconsin Hospital and Clinics or from Center for Digestive Diseases at Boston Medical Center.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non Randomized
- 干预模型
- Parallel
- 主要目的
- Basic Science
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 70 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient is between the ages of 18-70 years, inclusive.
- •History of primary varicella infection (chicken pox) Confirmed by a previous history of positive varicella zoster virus (VZV) Immunoglobulin G antibody or history of chicken pox
- •Patient has a history of ulcerative colitis (UC) or Crohn's disease diagnosed by standard clinical, radiographic, endoscopic, and histopathologic criteria.
- •Patient is receiving one of the following treatments for their IBD Group A: Anti-TNF monotherapy (adalimumab, certolizumab, golimumab, infliximab) Group B: Vedolizumab monotherapy
- •Patient has been on stable treatment for IBD for at least three months.
排除标准
- •Previous receipt of any HZ vaccine
- •Allergy to zoster vaccine or a component of it
- •Other underlying chronic medical condition that could affect immunogenicity to vaccines (rheumatoid arthritis, etc.)
- •History of herpes zoster or post herpetic neuralgia within the past year.
- •Patient cannot or will not provide written informed consent.
- •Patient is being administered immunomodulators currently or within the past three months
- •Patient has been taking any dose of oral or intravenous steroids within 30 days prior to immunization.
- •Patient has received polyclonal immunoglobulin therapy or blood products within the last year.
- •Patient is pregnant per self-reporting or older than age 70 years
- •Unable to provide appropriate informed consent due to being illiterate or impairment in decision-making capacity.
研究组 & 干预措施
Anti-TNF monotherapy
Patients with IBD on Anti-TNF monotherapy will be given the shingrix vaccine. Dose and Schedule: Two doses (0.5 mL each) administered intramuscularly according to the following schedule: A first dose at Month 0 followed by a second dose administered anytime between 2 and 6 months later.
干预措施: Shingrix (Biological)
Vedolizumab
Patients with IBD on vedolizumab monotherapy will be given the shingrix vaccine.
Dose and Schedule: Two doses (0.5 mL each) administered intramuscularly according to the following schedule: A first dose at Month 0 followed by a second dose administered anytime between 2 and 6 months later.
干预措施: Shingrix (Biological)
结局指标
主要结局
Change in Cell Mediated Immunity
时间窗: It will be measured from pre-immunization to 1 month after receiving second dose of booster vaccine post-immunization.
The primary objective will be the change in cell mediated immunity (CMI) as measured by ELISPOT from pre-immunization to one month after receiving second dose of vaccine.
次要结局
- Percent of Participants With Sustained Cell Mediated Immunity Measured Via ELISPOT After Immunization.(Baseline to 6 months post-immunization 2nd dose of vaccine.)
- Percent of Participants With a Change in Antibody Concentration Post Immunization(pre-immunization to one month 2nd dose post-immunization)
- Percent of Participants With a Change in Antibody Concentration That is Sustained at 6 Months(Baseline to 6 months post-immunization)
- Number of Participants Who Experienced Vaccine Related Adverse Events After Dose 1(Dose 1 (Month 0))
- Number of Participants Who Experienced Vaccine Related Adverse Events After Dose 2(Dose 2 (anytime from Month 2 to Month 6))
- Number of Participants Experiencing a Change in Disease Activity Post Immunization Reported(at the baseline visit and one month after receipt of each vaccine)