A phase II clinical trial of a Vi-DT typhoid conjugate vaccine in healthy Indonesian adolescents and adults: one-month evaluation of safety and immunogenicity

Sukamto Koesnoe1, Bernie Endyarni Medise2, Iris Rengganis1, Sri Rezeki Hadinegoro2, Mita Puspita3, Rini Mulia Sari3, Jae Seung Yang4, Sushant Sahastrabuddhe4, Soedjatmiko2, Hartono Gunardi2, Rini Sekartini2, Angga Wirahmadi2, Aria Kekalih5, Sreshta Mukhi2, Hindra Irawan Satari2, Novilia Sjafri Bachtiar3
1Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General National Hospital, Jakarta, Indonesia
2Department of Child Health, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General National Hospital, Jakarta, Indonesia
3PT. Bio Farma, Bandung, Indonesia
4International Vaccine Institute, Seoul, Republic of Korea
5Community Medicine Department, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General National Hospital, Jakarta, Indonesia

Tóm tắt

Typhoid fever is commonly found until today, especially in developing countries. It has fatal complications and measures must be taken to reduce the incidence of typhoid. Vaccinations are a key factor in prevention. This is a phase II randomized observer-blind clinical trial on a novel Vi-DT conjugate vaccine on 200 subjects 12 to 40 years of age. Subjects were screened for eligibility after which a blood sample was taken and one dose of vaccine was administered. Investigational vaccine used was Vi-DT and control was Vi-PS. Twenty-eight days after vaccination, subjects visited for providing blood sample to assess immunogenicity and were asked about local and systemic adverse reactions that occurred in the first 28 days. Subjects had minor adverse reactions. Pain was the most common local reaction. Muscle pain was the most common systemic reaction. There were no serious adverse events up to 28 days post vaccination. Seroconversion rates were 100% in the Vi-DT group and 95.96% in the Vi-PS group. Post vaccination GMTs were increased in both groups but it was significantly higher in the Vi-DT group (p < 0.001). Vi-DT typhoid conjugate vaccine is safe and immunogenic in healthy Indonesian subjects 12 to 40 years. Approved by ClinicalTrials.gov. Clinical trial registration number: NCT03460405. Registered on 09/03/2018. URL: https://clinicaltrials.gov/ct2/show/NCT03460405 .

Tài liệu tham khảo

Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. Typhoid Fever. N Engl J Med. 2002;347(22):1770–82. Crump JA. Progress in typhoid fever epidemiology. Clin Infect Dis 2019;68(Suppl 1): S4-9.https://doi.org/10.1093/cid/ciy846 pmid: 30767000. Luby SP. Urban slums: a supportive ecosytem for typhoidal salmonellae. J Infect Dis. 2018;218(suppl4):250–4. https://doi.org/10.1093/infdis/jiy324. Basnyat B, Qamar F, Rupali P, Ahmed T, Parry C. Clinical update: enteric Fever. BMJ 2021;372: n437 | doi: 10.1136/bmj. n437. Boggild AK, Castelli F, Gautret P, Torresi J, von Sonnenburg F, Barnett ED, Greenaway CA, Lim PL, Schwartz E, Wilder-Smith A, et al. Vaccine preventable Diseases in returned international travelers: results from the GeoSentinel surveillance network. Vaccine. 2010;28:7389–95. Bhandari J, Thada PK, DeVos E, Treasure Island S. ; 2022 ]. 2022. typhoid Fever. Nusrat N, Islam MR, Paul N, Rahman N, Krishnapillai A, Haq MA, Haque M. Clinical and Laboratory features of enteric Fever in children and antibiotic sensitivity pattern in a Tertiary Care Hospital of a low- and Middle-Income Country. Cureus. 2022;14(10):e30784. https://doi.org/10.7759/cureus.30784. PMID: 36320797; PMCID: PMC9614183. Antillón M, Warren JL, Crawford FW, et al. The burden of Typhoid Fever in low- and middle-income countries: a meta-regression approach. PLoS Negl Trop Dis. 2017;11:e0005376. https://doi.org/10.1371/journal.pntd.0005376. Hancuh M, Walldorf J, Minta AA, et al. Typhoid Fever surveillance, incidence estimates, and Progress toward Typhoid conjugate vaccine introduction — Worldwide, 2018–2022. MMWR Morb Mortal Wkly Rep. 2023;72:171–6. https://doi.org/10.15585/mmwr.mm7207a2. Crump JA, Sjölund-Karlsson M, Gordon MA, Parry CM. Epidemiology, clini- cal presentation, laboratory diagnosis, antimicrobial resistance, and antimi- crobial management of invasive Salmonella Infections. Clin Microbiol Rev. 2015;28(4):901–37. Pieters Z, Saad NJ, Antillón M, Pitzer VE, Bilcke J. Case fatality rate of enteric Fever in endemic countries: a systematic review and meta-analysis. Clin Infect Dis J. 2018;67:628–38. Pitzer VE, Feasey NA, Msefula C, Mallewa J, Kennedy N, Dube Q, et al. Math- ematical modeling to assess the drivers of the recent emergence of Typhoid Fever in Blantyre, Malawi. Clin Infect Dis J. 2015;61(suppl4):251–S2S8. The SAGE Working Group on typhoid Vaccines, WHO Secretariat. Background paper to SAGE on Typhoid vaccine policy recommendations. Geneva: World Health Organization; 2017. Syed K, Saluja T, Cho H. Review on the recent advances on Typhoid Vaccine Development and challenges ahead. Clin Infect Dis. 2020;71(S2):141–50. Neuzil K, Basnyat B, Clemens J, et al. Early insights from clinical trials of Typhoid Conjugate Vaccine. Clin Infect Dis. 2020;71(S2):155–9. Sahastrabuddhe S, Saluja T. Overview of the Typhoid conjugate vaccine pipeline: current status and future plans. Infect Dis Soc Am. 2019. https://doi.org/10.1093/cid/ciy884. Medise BE, Soedjatmiko S, Rengganis I, Gunardi H, Sekartini R, Koesno S, et al. Six-month follow up of a randomized clinical trial phase I study in Indonesian adults and children: Safety and immunogenicity of Salmonella typhi polysaccharide-diphtheria toxoid (Vi-DT) conjugate vaccine. PLoS ONE. 2019;14(2):e0211784. https://doi.org/10.1371/journal.pone.0211784. Medise BE, Soedjatmiko S, Gunardi H, Sekartini R, Satari HI, Hadinegoro SR, et al. One-month follow up of a randomized clinical trial-phase II study in 6 to < 24 months old Indonesian subjects: safety and immunogenicity of vi-DT Typhoid conjugate vaccine. Int J Infect Dis. 2020;93:102–7. https://doi.org/10.1016/j.ijid.2020.01.045. Medise BE, Soedjatmiko S, Gunardi H, Sekartini R, Satari HI, Hadinegoro SR, et al. A novel Vi-diphtheria toxoid Typhoid conjugate vaccine is safe and can induce immunogenicity in healthy Indonesian children 2–11 years: a phase II preliminary report. BMC Pediatr. 2020;20(480):1–8. Rijpkemaa S, Hockley J, Logana A, Rigsby P, Atkinson E, Jin C, et al. Establishment of the first international standard for human anti-typhoid capsular vi polysaccharide IgG. Biologicals. 2018;56:29–38. Capeding MR, Teshome S, Saluja T, Syed KA, Kim DR, Park JY, et al. Safety and immunogenicity of a vi-DT Typhoid conjugate vaccine: phase I trial in healthy Filipino adults and children. Vaccine. 2018;36:3794–801. Mohan VK, Varanasi V, Singh A, Pasetti MF, Levine MM, Venkatesan R, Ella KM. Safety and Immunogenicity of a vi polysaccharide–Tetanus Toxoid Conjugate Vaccine (Typbar-TCV) in healthy infants, children, and adults in Typhoid endemic areas: a Multicenter, 2-Cohort, Open-Label, Double-Blind, randomized controlled phase 3 study. Clin Infect Dis J. 2015;61(3):393–402. https://doi.org/10.1093/cid/civ295. Kundu S, Kandulna AK, Nayak U. Immunogenicity and safety of Typhoid Conjugate Vaccine in healthy Indian subjects: a Randomized, Active-controlled, comparative clinical trial. Indian Pediatr J. 2020;57:625–30.