Efficacy of the Herpes Zoster Subunit Vaccine in Adults 70 Years of Age or Older

Fecha de publicación:

Autores de FISABIO

  • Javier Diez Domingo

    Autor

  • Joan Puig Barberá

    Autor

Autores ajenos a FISABIO

  • Cunningham AL
  • Lal H
  • Kovac M
  • Chlibek R
  • Hwang SJ
  • Godeaux O
  • Levin MJ
  • McElhaney JE
  • Vanden Abeele C
  • Vesikari T
  • Watanabe D
  • Zahaf T
  • Ahonen A
  • Athan E
  • Barba-Gomez JF
  • Campora L
  • de Looze F
  • Downey HJ
  • Ghesquiere W
  • Gorfinkel I
  • Korhonen T
  • Leung E
  • McNeil SA
  • Oostvogels L
  • Rombo L
  • Smetana J
  • Weckx L
  • Yeo W
  • Heineman TC
  • ZOE-70 Study Group

Grupos de Investigación

Abstract

BACKGROUND A trial involving adults 50 years of age or older (ZOE-50) showed that the herpes zoster subunit vaccine (HZ/su) containing recombinant varicella-zoster virus glycoprotein E and the AS01(B) adjuvant system was associated with a risk of herpes zoster that was 97.2% lower than that associated with placebo. A second trial was performed concurrently at the same sites and examined the safety and efficacy of HZ/su in adults 70 years of age or older (ZOE-70). METHODS This randomized, placebo-controlled, phase 3 trial was conducted in 18 countries and involved adults 70 years of age or older. Participants received two doses of HZ/su or placebo (assigned in a 1: 1 ratio) administered intramuscularly 2 months apart. Vaccine efficacy against herpes zoster and postherpetic neuralgia was assessed in participants from ZOE-70 and in participants pooled from ZOE-70 and ZOE-50. RESULTS In ZOE-70, 13,900 participants who could be evaluated (mean age, 75.6 years) received either HZ/su (6950 participants) or placebo (6950 participants). During a mean follow-up period of 3.7 years, herpes zoster occurred in 23 HZ/su recipients and in 223 placebo recipients (0.9 vs. 9.2 per 1000 person-years). Vaccine efficacy against herpes zoster was 89.8% (95% confidence interval [CI], 84.2 to 93.7; P<0.001) and was similar in participants 70 to 79 years of age (90.0%) and participants 80 years of age or older (89.1%). In pooled analyses of data from participants 70 years of age or older in ZOE-50 and ZOE-70 (16,596 participants), vaccine efficacy against herpes zoster was 91.3% (95% CI, 86.8 to 94.5; P<0.001), and vaccine efficacy against postherpetic neuralgia was 88.8% (95% CI, 68.7 to 97.1; P<0.001). Solicited reports of injection-site and systemic reactions within 7 days after injection were more frequent among HZ/su recipients than among placebo recipients (79.0% vs. 29.5%). Serious adverse events, potential immune-mediated diseases, and deaths occurred with similar frequencies in the two study groups. CONCLUSIONS In our trial, HZ/su was found to reduce the risks of herpes zoster and postherpetic neuralgia among adults 70 years of age or older. (Funded by GlaxoSmithKline Biologicals; ZOE-50 and ZOE-70 ClinicalTrials.govnumbers, NCT01165177 and NCT01165229.)

Datos de la publicación

ISSN/ISSNe:
0028-4793, 1533-4406

NEW ENGLAND JOURNAL OF MEDICINE  MASSACHUSETTS MEDICAL SOC

Tipo:
Article
Páginas:
1019-1032

Citas Recibidas en Web of Science: 679

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