Safety and efficacy of a cytomegalovirus glycoprotein B (gB) vaccine in adolescent girls: A randomized clinical trial

被引:179
作者
Bernstein, David I. [1 ]
Munoz, Flor M. [2 ]
Callahan, S. Todd [3 ]
Rupp, Richard [4 ]
Wootton, Susan H. [5 ]
Edwards, Kathryn M. [3 ]
Turley, Christine B. [4 ,6 ]
Stanberry, Lawrence R. [4 ,7 ]
Patel, Shital M. [2 ]
Mcneal, Monica M. [1 ]
Pichon, Sylvie [8 ]
Amegashie, Cyrille [9 ]
Bellamy, Abbie R. [9 ]
机构
[1] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA
[2] Baylor Coll Med, Houston, TX 77030 USA
[3] Vanderbilt Univ, Med Ctr, Nashville, TN USA
[4] Univ Texas Med Branch, Galveston, TX 77555 USA
[5] Univ Texas Hlth Sci Ctr Houston, Houston, TX 77030 USA
[6] Univ S Carolina, Sch Med, Columbia, SC USA
[7] Columbia Univ, New York Presbyterian Hosp, New York, NY USA
[8] Sanofi Pasteur, Marcy Letoile, France
[9] Emmes Corp, Rockville, MD USA
关键词
Cytomegalovirus; Vaccine; Adolescent; CMV gB; TRANSPLANT RECIPIENTS; CMV INFECTION; PREVENTION; DISEASE; DNA; IMMUNITY; ADJUVANT; PLASMA;
D O I
10.1016/j.vaccine.2015.11.056
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Cytomegalovirus (CMV) is a leading cause of congenital infection and an important target for vaccine development. Methods: CMV seronegative girls between 12 and 17 years of age received CMV glycoprotein B (gB) vaccine with MF59 or saline placebo at 0, 1 and 6 months. Blood and urine were collected throughout the study for evidence of CMV infection based on PCR and/or seroconversion to non-vaccine CMV antigens. Results: 402 CMV seronegative subjects were vaccinated (195 vaccine, 207 placebo). The vaccine was generally well tolerated, although local and systemic adverse events were significantly more common in the vaccine group. The vaccine induced gB antibody in all vaccine recipients with a gB geometric mean titer of 13,400 EU; 95%CI 11,436, 15,700, after 3 doses. Overall, 48 CMV infections were detected (21 vaccine, 27 placebo). In the per protocol population (124 vaccine, 125 placebo) vaccine efficacy was 43%; 95%CI: -36; 76, p = 0.20. The most significant difference was after 2 doses, administered as per protocol; vaccine efficacy 45%, 95%CI: -9; 72, p = 0.08. Conclusion: The vaccine was safe and immunogenic. Although the efficacy did not reach conventional levels of significance, the results are consistent with a previous study in adult women (Pass et al. N Engl J Med 2009;360:1191) using the same formulation. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:313 / 319
页数:7
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