Sutradhar Santosh C, Wang William W B, Schlienger Katia, Stek Jon E, Xu Jin, Chan Ivan S F, Silber Jeffrey L
Merck Research Laboratories, Upper Gwynedd, Pennsylvania, USA.
Clin Vaccine Immunol. 2009 May;16(5):646-52. doi: 10.1128/CVI.00407-08. Epub 2009 Mar 4.
Zostavax has been shown to be efficacious in the prevention of herpes zoster and generally well tolerated in clinical trials among subjects 60 years old or older. This prespecified combined analysis from two studies compares the levels of immunogenicity and safety of Zostavax in subjects 50 to 59 years old versus those in subjects >or=60 years old. Varicella-zoster virus (VZV) antibody (Ab) titers were measured by glycoprotein enzyme-linked immunosorbent assay at baseline and 4 weeks postvaccination. Noninferiority was evaluated by estimated geometric mean severalfold rise (GMFR) ratio (50 to 59 years old/>or=60 years old) and two-sided 95% confidence interval (CI). Success was defined by a lower bound (LB) of the 95% CI of the GMFR ratio of >0.67. Acceptability of postvaccination VZV Ab was defined by an LB of the 95% CI of the GMFR of >1.4. Safety data were recorded for 28 days postvaccination by standardized vaccination report card. The estimated GMFRs from baseline to 4 weeks postvaccination were 2.6 (95% CI, 2.4, 2.9) in subjects 50 to 59 years old and 2.3 (95% CI, 2.1, 2.4) in subjects >or=60 years old. The estimated GMFR ratio (50 to 59 years old/>or=60 years old) was 1.13 (95% CI, 1.02, 1.25). No serious Zostavax-related adverse experiences were reported. After a dose of Zostavax, the GMFR of the VZV Ab response in subjects 50 to 59 years old was noninferior to that in subjects >or=60 years old. The VZV Ab response was acceptable in both age groups. Zostavax was generally well tolerated in both age groups.
Zostavax已被证明在预防带状疱疹方面有效,并且在60岁及以上受试者的临床试验中总体耐受性良好。这项来自两项研究的预先设定的综合分析比较了Zostavax在50至59岁受试者与60岁及以上受试者中的免疫原性水平和安全性。在基线和接种疫苗后4周,通过糖蛋白酶联免疫吸附测定法测量水痘带状疱疹病毒(VZV)抗体(Ab)滴度。通过估计几何平均几倍升高(GMFR)比率(50至59岁/60岁及以上)和双侧95%置信区间(CI)评估非劣效性。成功的定义是GMFR比率的95%CI下限(LB)>0.67。接种疫苗后VZV Ab的可接受性定义为GMFR的95%CI下限>1.4。通过标准化疫苗接种报告卡记录接种疫苗后28天的安全数据。接种疫苗后4周从基线开始的估计GMFR在50至59岁受试者中为2.6(95%CI,2.4,2.9),在60岁及以上受试者中为2.3(95%CI,2.1,2.4)。估计的GMFR比率(50至59岁/60岁及以上)为1.13(95%CI,1.02,1.25)。未报告与Zostavax相关的严重不良事件。一剂Zostavax后,50至59岁受试者中VZV Ab反应的GMFR不劣于60岁及以上受试者。两个年龄组的VZV Ab反应均可接受。Zostavax在两个年龄组中总体耐受性良好。