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Sabin 株来源的灭活脊灰病毒疫苗的安全性和免疫原性:一项 II 期、随机、剂量探索试验。

Safety and immunogenicity of inactivated poliovirus vaccine made from Sabin strains: A phase II, randomized, dose-finding trial.

机构信息

Jiangsu Province Center for Disease Control and Prevention, Jiangsu, China.

National Institutes for Food and Drug Control, Beijing, China.

出版信息

Vaccine. 2018 Oct 29;36(45):6782-6789. doi: 10.1016/j.vaccine.2018.09.023. Epub 2018 Sep 21.

Abstract

BACKGROUND

In order to completely eradicate polio caused by wild poliovirus infection as well as vaccine-associated paralytic polio (VAPP), Sabin inactivated poliovirus vaccine (sIPV) should be developed to meet the requirements for biosafety and affordable strategy in the developing countries.

METHOD

A randomized, double-blinded clinical trial was conducted to compare the immunogenicity and safety among infants aged 2 months (60-90 days) receiving five different vaccination regimens: the test groups (A, B, and C) received three doses of sIPV with high, medium, and low D antigen content, respectively, on the month 0, 1, 2 schedule; two control groups (D and E) received three doses of conventional IPV (cIPV) or sIPV (CAMS), respectively, on the same schedule as that of test groups. Serum samples were collected immediately before the 1st dose and 30 days after the 3rd dose vaccination to assess the immunogenicity. Adverse events occurring within 30 days after each dose were collected to assess the safety.

RESULTS

After three doses, seroconversion rates in groups A-E were 100%, 98.2%, 100%, 100%, and 100%, respectively, for type 1; 99.1%, 100%, 98.1%, 100%, and 97.1%, respectively, for type 2; and 100%, 100%, 100%, 100%, and 99.0%, respectively, for type 3. The seropositive rates (≥1:8) of groups A-E for all types were nearly 100%. The GMTs in the target dose group (group B) were 4635, 342, and 2218 for type 1-3, respectively. The most common injection-site and systemic adverse reactions were swelling and fever respectively. The swelling (4.2%, P = 0.0075) and fever (58.3%, P = 0.0188) frequency of group A were statistically significantly higher than any other groups.

CONCLUSION

The test sIPV generally demonstrated good safety and immunogenicity. The medium-D antigen dose would be a preferred choice for the further phase III clinical trial in consideration of its high immunogenicity for all serotypes and the satisfying tolerance.

CLINICAL TRIALS REGISTRATION

NCT02985320.

摘要

背景

为彻底消灭野病毒引起的脊灰和疫苗衍生脊灰病毒(VAPP),需要研制符合发展中国家生物安全和可负担性策略的 Sabin 脊灰灭活疫苗(sIPV)。

方法

采用随机、双盲临床试验,比较 2 月龄(60~90 日龄)婴儿接受 5 种不同免疫程序的免疫原性和安全性:试验组(A、B 和 C)在 0、1、2 月龄时分别接种 3 剂高、中、低剂量 D 抗原 sIPV;对照组(D 和 E)在相同时间分别接种 3 剂常规 IPV(cIPV)或 CAMS 来源 sIPV。在首剂和第 3 剂后 30 天采集血清样本,评估免疫原性。采集每次接种后 30 天内的不良事件,评估安全性。

结果

3 剂后,AE 组 1 型血清转化率均为 100%,2 型为 99.1%100%,3 型为 100%100%;1 型、2 型和 3 型血清阳转率(≥1∶8)均接近 100%。目标剂量组(B 组)13 型血清 GMT 分别为 4635、342 和 2218。最常见的注射部位和全身不良反应分别为肿胀和发热。A 组肿胀(4.2%,P=0.0075)和发热(58.3%,P=0.0188)频率显著高于其他组。

结论

试验 sIPV 一般具有良好的安全性和免疫原性。考虑到对所有血清型的高免疫原性和满意的耐受性,中剂量 D 抗原可能是进一步开展 III 期临床试验的首选。

临床试验注册

NCT02985320。

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