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呼吸道合胞病毒候选疫苗 3 种制剂在非孕妇女性中的免疫原性和安全性:一项 2 期随机试验。

Immunogenicity and Safety of 3 Formulations of a Respiratory Syncytial Virus Candidate Vaccine in Nonpregnant Women: A Phase 2, Randomized Trial.

机构信息

Institute of Laboratory Medicine and Vaccination Centre, Klinikum Würzburg Mitte, Würzburg, Germany.

GlaxoSmithKline (GSK), Rockville, Maryland.

出版信息

J Infect Dis. 2019 Oct 22;220(11):1816-1825. doi: 10.1093/infdis/jiz395.

Abstract

BACKGROUND

Respiratory syncytial virus (RSV) is a common cause of respiratory tract illness and hospitalization in neonates and infants. RSV vaccination during pregnancy may protect offspring in their first months of life.

METHODS

This randomized, observer-blind, multicenter, phase 2 study evaluated the immunogenicity and safety of an RSV candidate vaccine in healthy nonpregnant women aged 18-45 years. Four hundred participants were randomized (1:1:1:1) to receive a single intramuscular dose of vaccine containing 30 µg, 60 µg, or 120 µg of RSV fusion protein engineered to preferentially maintain a prefusion conformation (RSV-PreF vaccine) or placebo.

RESULTS

Thirty days postvaccination, RSV-A neutralizing antibody geometric mean titers (GMTs) increased 3.75-, 4.42- and 4.36-fold; RSV-B neutralizing antibody GMTs 2.36-, 2.54- and 2.76-fold; and palivizumab competing antibody (PCA) concentrations 11.69-, 14.38- and 14.24-fold compared with baseline levels in the 30 µg, 60 µg, and 120 µg RSV-PreF groups, respectively. Antibody titers and PCA concentrations at day 30 were significantly higher with the 120 µg compared to the 30 µg RSV-PreF vaccine. All RSV-PreF vaccine formulations and the placebo had similar reactogenicity profiles. No serious adverse events were considered to be related to the RSV-PreF vaccine.

CONCLUSIONS

The 3 formulations of the investigational RSV-PreF vaccine were well-tolerated and induced RSV-A and RSV-B neutralizing antibodies and PCAs in healthy, nonpregnant women.

CLINICAL TRIALS REGISTRATION

NCT02956837.

摘要

背景

呼吸道合胞病毒(RSV)是导致新生儿和婴儿呼吸道疾病和住院的常见原因。在怀孕期间接种 RSV 疫苗可能会保护婴儿在生命的头几个月。

方法

这项随机、观察者盲法、多中心、2 期研究评估了一种 RSV 候选疫苗在 18-45 岁健康未怀孕女性中的免疫原性和安全性。400 名参与者按 1:1:1:1 的比例随机分配,接受含 30μg、60μg 或 120μg RSV 融合蛋白的单剂肌内注射,该融合蛋白经过工程改造,优先维持融合前构象(RSV-PreF 疫苗)或安慰剂。

结果

接种后 30 天,RSV-A 中和抗体几何平均滴度(GMT)分别增加了 3.75 倍、4.42 倍和 4.36 倍;RSV-B 中和抗体 GMT 分别增加了 2.36 倍、2.54 倍和 2.76 倍;帕利珠单抗竞争抗体(PCA)浓度分别增加了 11.69 倍、14.38 倍和 14.24 倍,与 30μg、60μg 和 120μg RSV-PreF 组的基线水平相比。与 30μg RSV-PreF 疫苗相比,120μg RSV-PreF 疫苗在第 30 天的抗体滴度和 PCA 浓度更高。所有 RSV-PreF 疫苗制剂和安慰剂的不良反应谱相似。没有认为与 RSV-PreF 疫苗相关的严重不良事件。

结论

3 种研究性 RSV-PreF 疫苗制剂均具有良好的耐受性,可诱导健康未怀孕女性产生 RSV-A 和 RSV-B 中和抗体和 PCA。

临床试验注册

NCT02956837。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0211/6898794/a0b88f620035/jiz395f0001.jpg

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