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接种HPV-16/18 AS04佐剂疫苗2剂或3剂后长达4年的免疫反应:一项随机研究的结果

Immune response to the HPV-16/18 AS04-adjuvanted vaccine administered as a 2-dose or 3-dose schedule up to 4 years after vaccination: results from a randomized study.

作者信息

Romanowski Barbara, Schwarz Tino F, Ferguson Linda M, Ferguson Murdo, Peters Klaus, Dionne Marc, Schulze Karin, Ramjattan Brian, Hillemanns Peter, Behre Ulrich, Suryakiran Pemmaraju, Thomas Florence, Struyf Frank

机构信息

University of Alberta; Edmonton, AB Canada.

Central Laboratory and Vaccination Centre; Stiftung Juliusspital; Würzburg, Germany.

出版信息

Hum Vaccin Immunother. 2014;10(5):1155-65. doi: 10.4161/hv.28022. Epub 2014 Feb 27.

Abstract

This randomized, partially-blind study (ClinicalTrials.gov registration number NCT00541970) evaluated the immunogenicity and safety of 2-dose (2D) schedules of the HPV-16/18 AS04-adjuvanted vaccine. Results to month (M) 24 have been reported previously and we now report data to M48 focusing on the licensed vaccine formulation (20 μg each of HPV-16 and -18 antigens) administered at M0,6 compared with the standard 3-dose (3D) schedule (M0,1,6). Healthy females (age stratified: 9-14, 15-19, 20-25 years) were randomized to receive 2D at M0,6 (n = 240) or 3D at M0,1,6 (n = 239). In the according-to-protocol immunogenicity cohort, all initially seronegative subjects seroconverted for HPV-16 and -18 antibodies and remained seropositive up to M48. For both HPV-16 and -18, geometric mean antibody titer (GMT) ratios (3D schedule in women aged 15-25 years divided by 2D schedule in girls aged 9-14 years) at M36 and M48 were close to 1, as they were at M7 when non-inferiority was demonstrated. The kinetics of HPV-16, -18, -31, and -45 antibody responses were similar for both groups and HPV-16 and -18 GMTs were substantially higher than natural infection titers. The vaccine had a clinically acceptable safety profile in both groups. In summary, antibody responses to a 2D M0,6 schedule of the licensed vaccine formulation in girls aged 9-14 years appeared comparable to the standard 3D schedule in women aged 15-25 years up to 4 years after first vaccination. A 2D schedule could facilitate implementation of HPV vaccination programs and improve vaccine coverage and series completion rates.

摘要

这项随机、部分盲法研究(ClinicalTrials.gov注册号NCT00541970)评估了HPV-16/18 AS04佐剂疫苗2剂(2D)接种方案的免疫原性和安全性。此前已报告至第24个月(M)的结果,我们现在报告至第48个月的数据,重点关注在第0、6个月接种的已获许可疫苗配方(HPV-16和-18抗原各20μg),并与标准3剂(3D)接种方案(第0、1、6个月)进行比较。健康女性(按年龄分层:9-14岁、15-19岁、20-25岁)被随机分为在第0、6个月接受2D接种(n = 240)或在第0、1、6个月接受3D接种(n = 239)。在符合方案的免疫原性队列中,所有最初血清学阴性的受试者均出现HPV-16和-18抗体血清转化,并且在第48个月时仍保持血清学阳性。对于HPV-16和-18,在第36个月和第48个月时的几何平均抗体滴度(GMT)比值(15-25岁女性的3D接种方案除以9-14岁女孩的2D接种方案)接近1,与证明非劣效性时的第7个月情况相同。两组HPV-16、-18、-31和-45抗体反应的动力学相似,HPV-16和-18的GMT显著高于自然感染滴度。该疫苗在两组中均具有临床可接受的安全性。总之,9-14岁女孩对已获许可疫苗配方的2D第0、6个月接种方案的抗体反应在首次接种后4年内似乎与15-25岁女性的标准3D接种方案相当。2D接种方案可促进HPV疫苗接种计划的实施,并提高疫苗接种覆盖率和全程接种率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/229c/4896558/3431ed38b587/khvi-10-05-10928022-g001.jpg

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本文引用的文献

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Pooled analysis of large and long-term safety data from the human papillomavirus-16/18-AS04-adjuvanted vaccine clinical trial programme.
Pharmacoepidemiol Drug Saf. 2014 May;23(5):466-79. doi: 10.1002/pds.3554. Epub 2014 Feb 20.
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Immune responses elicited by a fourth dose of the HPV-16/18 AS04-adjuvanted vaccine in previously vaccinated adult women.
Vaccine. 2012 Dec 17;31(1):234-41. doi: 10.1016/j.vaccine.2012.09.037. Epub 2012 Oct 11.
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Sustained immunogenicity and efficacy of the HPV-16/18 AS04-adjuvanted vaccine: up to 8.4 years of follow-up.
Hum Vaccin Immunother. 2012 Mar;8(3):390-7. doi: 10.4161/hv.18865. Epub 2012 Feb 13.

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