评估 RSVPreF3 OA 与 FLU-QIV-HD 联合给药对年龄≥ 65 岁成人的免疫原性、安全性和反应生成性的随机、开放标签 3 期研究。

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES
Infectious Diseases and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-26 DOI:10.1007/s40121-024-00985-4
Robert Buynak, Kevin Cannon, David DeAtkine, John Kirby, Lisa Usdan, Amit Bhavsar, Catherine Gérard, Anastasia Kuznetsova, Amulya Jayadev, Hiwot Amare, Sofia Valenciano, Nadia Meyer
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引用次数: 0

摘要

导言:由于免疫系统老化和合并症,呼吸道合胞病毒(RSV)和流感给老年人带来了沉重的疾病负担;这两种感染存在季节性重叠。2023 年,RSV 预融合蛋白 F3 老年人(RSVPreF3 OA)疫苗首次在美国获批,单剂用于预防年龄≥ 60 岁的成年人因 RSV 引起的下呼吸道疾病。此后,欧盟和其他国家也批准了该疫苗。如果免疫原性、安全性和反应性不受影响,RSVPreF3 OA和FLU-QIV-HD可联合使用:这项开放标签、随机(1:1)、对照、3 期研究在美国 1029 名年龄≥ 65 岁的成年人中进行,评估了 RSVPreF3 OA 与 FLU-QIV-HD 联合用药(联合用药组)与单独用药 FLU-QIV-HD,然后在 1 个月后单独就诊时接种 RSVPreF3 OA(对照组)的免疫原性(最后一次接种后 1 个月内)和安全性(最后一次接种后 6 个月内)。非劣效性标准定义为几何平均滴度(GMT)组比(对照组/联合添加组)的双侧 95% 置信区间上限≤1.5。次要终点包括安全性和反应性:各组间不同年龄段参与者的比例以及男性(50.4%)和女性(49.6%)参与者的比例非常均衡;大多数参与者为白人(68.7%)。联合接种组与对照组相比,RSV-A 中和滴度、四种流感疫苗株的血凝抑制滴度和 RSV-B 中和滴度的组间 GMT 比值均无差别。在局部或全身性主动和非主动不良事件(AE)、严重AE和潜在免疫介导疾病方面,未发现有临床意义的差异。两组最常见的主动不良反应是注射部位疼痛和肌痛:结论:在年龄≥65岁的成年人中,RSVPreF3 OA和FLU-QIV-HD联合给药在免疫原性上不劣于两种疫苗间隔1个月的连续给药,其安全性和反应性概况在临床上可接受:试验注册:ClinicalTrials.gov 识别码,NCT05559476。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Randomized, Open-Label Phase 3 Study Evaluating Immunogenicity, Safety, and Reactogenicity of RSVPreF3 OA Coadministered with FLU-QIV-HD in Adults Aged ≥ 65.

Randomized, Open-Label Phase 3 Study Evaluating Immunogenicity, Safety, and Reactogenicity of RSVPreF3 OA Coadministered with FLU-QIV-HD in Adults Aged ≥ 65.

Introduction: Respiratory syncytial virus (RSV) and influenza pose major disease burdens in older adults due to an aging immune system and comorbidities; seasonal overlap exists between these infections. In 2023, the RSV prefusion protein F3 older adult (RSVPreF3 OA) vaccine was first approved in the USA as a single dose for prevention of lower respiratory tract disease due to RSV in adults aged ≥ 60 years. The vaccine has since been approved in the European Union and elsewhere. RSVPreF3 OA and FLU-QIV-HD could be coadministered if immunogenicity, safety, and reactogenicity are not affected.

Methods: This open-label, randomized (1:1), controlled, phase 3 study in 1029 adults aged ≥ 65 years in the USA evaluated the immunogenicity (up to 1 month after last vaccine dose) and safety (up to 6 months after last vaccine dose) of RSVPreF3 OA coadministered with FLU-QIV-HD (co-ad group) versus FLU-QIV-HD alone followed by RSVPreF3 OA at a separate visit 1 month later (control group). Non-inferiority criterion was defined as an upper limit of the two-sided 95% confidence interval of the geometric mean titer (GMT) group ratio (control/co-ad) ≤ 1.5. Secondary endpoints included safety and reactogenicity.

Results: Proportions of participants across age categories between groups and proportions of male (50.4%) and female (49.6%) participants were well balanced; most participants were white (68.7%). Group GMT ratios for RSV-A neutralizing titers, hemagglutination inhibition titers for four influenza vaccine strains, and RSV-B neutralizing titers were non-inferior in the co-ad group versus the control group. No clinically meaningful differences in local or systemic solicited and unsolicited adverse events (AEs), serious AEs, and potential immune-mediated diseases were identified. The most common solicited AEs in both groups were injection-site pain and myalgia.

Conclusion: In adults aged ≥ 65 years, coadministration of RSVPreF3 OA and FLU-QIV-HD was immunogenically non-inferior to the sequential administration of both vaccines 1 month apart, and had clinically acceptable safety and reactogenicity profile.

Trial registration: ClinicalTrials.gov identifier, NCT05559476.

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来源期刊
Infectious Diseases and Therapy
Infectious Diseases and Therapy Medicine-Microbiology (medical)
CiteScore
8.60
自引率
1.90%
发文量
136
审稿时长
6 weeks
期刊介绍: Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.
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