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    Home > Active Ingredient News > Infection > Ann Intern Med: Safety and immunological efficacy of live varicella-zoster vaccine in patients receiving tumor necrosis factor inhibitors

    Ann Intern Med: Safety and immunological efficacy of live varicella-zoster vaccine in patients receiving tumor necrosis factor inhibitors

    • Last Update: 2022-01-22
    • Source: Internet
    • Author: User
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    The safety and efficacy of live viral vaccines, such as the varicella-zoster vaccine, in patients with inflammatory diseases receiving immunomodulatory
    therapy, such as tumor necrosis factor inhibitors (TNFis), are unknown .
    A study published in Ann Intern Med evaluated the safety and immunogenicity of live attenuated varicella vaccine (ZVL) in patients treated with TNFis

    .

    immunity

    Using a randomized, blinded, placebo-controlled design, adults 50 years of age and older receiving TNFis were randomized to ZVL versus placebo
    .
    Glycoproteinase-linked immunosorbent assay (gpELISA) and enzyme-linked immunosorbent assay (ELISpot) of serum and peripheral blood mononuclear cells were measured at baseline and 6 weeks after vaccination

    .
    Suspected varicella or herpes zoster
    infection
    was assessed by digital photographs and polymerase chain reaction of vesicular fluid .

    Infect

     

    RESULTS: From March 2015 to December 2018, a total of 617 participants were included in the study, randomized 1:1 to receive ZVL (n = 310) or placebo (n = 307) at 33 centers
    .
    Mean age was 62.
    7 years (SD, 7.
    5); 66.
    1% of participants were female, 90% white, 8.
    2% black, and 5.
    9% Hispanic

    .
    The most common TNFi indications were
    rheumatoid arthritis (57.
    6%) and psoriatic arthritis (24.
    1%); TNFi drugs were adalimumab (32.
    7%), infliximab (31.
    3%), enamel chypre (21.
    2%), golimumab (9.
    1%), and cetocilizumab (5.
    7%)

    .
    Concurrent treatments included methotrexate (48.
    0%) and oral corticosteroids (10.
    5%)

    .
    By week 6, no confirmed cases of varicella infection were identified; the cumulative incidence of varicella infection or shingles was 0.
    0% (95% CI, 0.
    0%-1.
    2%)

    .
    At 6 weeks, the mean of the geometric mean fold rise measured by gpELISA and ELISpot was 1.
    33 percentage points (CI, 1.
    17-1.
    51%) and 1.
    39 percentage points (CI, 1.
    07-1.
    82%), respectively, from baseline

    .

    rheumatoid arthritis

     

    Taken together, the findings provide evidence for the safety of live virus vaccines in patients receiving biologics
    .
    A limitation of the study is that generalizability to patients receiving other types of immunomodulators may be limited

    .

     

    Original source:

     

    Jeffrey R Curtis, et al.
    ,
    The Safety and Immunologic Effectiveness of the Live Varicella-Zoster Vaccine in Patients Receiving Tumor Necrosis Factor Inhibitor Therapy : A Randomized Controlled Trial .
    Ann Intern Med.
    2021 Nov;174(11):1510-1518.
    doi: 10.
    7326/M20-6928.

    The Safety and Immunologic Effectiveness of the Live Varicella-Zoster Vaccine in Patients Receiving Tumor Necrosis Factor Inhibitor Therapy : A Randomized Controlled Trial

     



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