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佐剂重组带状疱疹疫苗的安全性概况:两项大型随机 3 期临床试验的汇总分析。

Safety profile of the adjuvanted recombinant zoster vaccine: Pooled analysis of two large randomised phase 3 trials.

机构信息

GSK, Wavre, Belgium.

GSK, Rixensart, Belgium.

出版信息

Vaccine. 2019 Apr 24;37(18):2482-2493. doi: 10.1016/j.vaccine.2019.03.043. Epub 2019 Mar 29.

Abstract

BACKGROUND

The ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229) phase 3 clinical trials showed that the adjuvanted recombinant zoster vaccine (RZV) was ≥90% efficacious in preventing herpes zoster in adults. Here we present a comprehensive overview of the safety data from these studies.

METHODS

Adults aged ≥50 (ZOE-50) and ≥70 (ZOE-70) years were randomly vaccinated with RZV or placebo. Safety analyses were performed on the pooled total vaccinated cohort, consisting of participants receiving at least one dose of RZV or placebo. Solicited and unsolicited adverse events (AEs) were collected for 7 and 30 days after each vaccination, respectively. Serious AEs (SAEs) were collected from the first vaccination until 12 months post-last dose. Fatal AEs, vaccination-related SAEs, and potential immune-mediated diseases (pIMDs) were collected during the entire study period.

RESULTS

Safety was evaluated in 14,645 RZV and 14,660 placebo recipients. More RZV than placebo recipients reported unsolicited AEs (50.5% versus 32.0%); the difference was driven by transient injection site and solicited systemic reactions that were generally seen in the first week post-vaccination. The occurrence of overall SAEs (RZV: 10.1%; Placebo: 10.4%), fatal AEs (RZV: 4.3%; Placebo: 4.6%), and pIMDs (RZV: 1.2%; Placebo: 1.4%) was balanced between groups. The occurrence of possible exacerbations of pIMDs was rare and similar between groups. Overall, except for the expected local and systemic symptoms, the safety results were comparable between the RZV and Placebo groups irrespective of participant age, gender, or race.

CONCLUSIONS

No safety concerns arose, supporting the favorable benefit-risk profile of RZV.

摘要

背景

ZOE-50(NCT01165177)和 ZOE-70(NCT01165229)三期临床试验表明,佐剂重组带状疱疹疫苗(RZV)在预防成人带状疱疹方面的有效性≥90%。在此,我们对这些研究的安全性数据进行了全面综述。

方法

年龄≥50 岁(ZOE-50)和≥70 岁(ZOE-70)的成年人被随机接种 RZV 或安慰剂。安全性分析基于接受至少一剂 RZV 或安慰剂的总接种人群进行。分别在每次接种后 7 天和 30 天收集有症状和无症状不良事件(AE)。严重不良事件(SAE)从第一次接种开始收集,直到最后一次给药后 12 个月。在整个研究期间收集致命不良事件、与疫苗接种相关的 SAE 和潜在免疫介导的疾病(pIMD)。

结果

安全性评估纳入了 14645 名 RZV 接种者和 14660 名安慰剂接种者。与安慰剂组相比,更多的 RZV 接种者报告了无症状不良事件(50.5%对 32.0%);这种差异是由疫苗接种后第一周出现的短暂注射部位和全身性反应引起的。总的 SAE(RZV:10.1%;安慰剂:10.4%)、致命 AEs(RZV:4.3%;安慰剂:4.6%)和 pIMD(RZV:1.2%;安慰剂:1.4%)的发生率在两组之间平衡。pIMD 恶化的可能性较小,两组之间相似。总体而言,除了预期的局部和全身症状外,RZV 和安慰剂组的安全性结果在不同年龄、性别或种族的参与者中均相似。

结论

没有出现安全性问题,支持 RZV 良好的获益风险比。

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