Zostavax in Systemic Lupus Erythematosus

NCT ID: NCT01474720

Last Updated: 2013-09-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-11-30

Study Completion Date

2012-10-31

Brief Summary

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Individuals with systemic lupus erythematosus (SLE, lupus) appear to be at increased risk for the development of shingles, a painful reactivation of the varicella zoster virus that causes chicken pox.

The investigators propose to study the immune response to commercially available Zostavax vaccine (shingles vaccine) in adult patients with SLE who have minimal disease activity and are on mild immunosuppressant medications, and to compare the immune response to that seen in healthy people following vaccination. Acceptable immunosuppressive drugs permitted in the study are those felt to be safe according to Centers for Disease Control guidelines.

Ten healthy people and 10 SLE patients (all over 50 years of age) will be recruited to receive a single, standard dose of Zostavax. Blood samples and physical examination will be performed prior to injection, then 2,6,and 12 weeks following vaccination. All participants will receive active vaccine, there is no placebo group.

Detailed Description

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Conditions

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Systemic Lupus Erythematosus

Keywords

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Systemic Lupus Erythematosus Lupus SLE Zostavax shingles

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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SLE patients

Subjects with mild SLE over age 50 years will receive open-label Zostavax vaccine.

Group Type EXPERIMENTAL

Zostavax vaccine

Intervention Type DRUG

Commercially available Zostavax vaccine will be administered subcutaneously according to package insert guidelines. Each 0.65-mL dose contains a minimum of 19,400 PFU (plaque-forming units) of Oka/Merck strain of VZV.

Healthy subjects

Healthy subjects aged 50 years and older without any history of autoimmune disease will receive zostavax vaccine. Immune responses to varicella zoster virus and adverse events will be compared to those seen in SLE patients

Group Type ACTIVE_COMPARATOR

Zostavax vaccine

Intervention Type DRUG

Commercially available Zostavax vaccine will be administered subcutaneously according to package insert guidelines. Each 0.65-mL dose contains a minimum of 19,400 PFU (plaque-forming units) of Oka/Merck strain of VZV.

Interventions

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Zostavax vaccine

Commercially available Zostavax vaccine will be administered subcutaneously according to package insert guidelines. Each 0.65-mL dose contains a minimum of 19,400 PFU (plaque-forming units) of Oka/Merck strain of VZV.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 50 years
* Willing and able to provide written informed consent
* History of primary varicella vaccination or positive VZV IgG antibodies
* Diagnosis of SLE according to ACR criteria for \> 1 year; or healthy control subject
* Stable, mild disease activity as defined by a clinical SLEDAI score ≤ 4
* Current medical treatment for SLE has been stable for 4 weeks prior to screening
* Acceptable immunosuppressive medications are limited to
* Prednisone ≤ 10 mg daily
* Methotrexate ≤ 20 mg weekly
* Azathioprine ≤ 150 mg daily
* Hydroxychloroquine ≤ 6.5 mg/kg daily
* Female subjects of childbearing potential and non-sterile males must agree to use acceptable form of contraception for the duration of the study

Exclusion Criteria

* History of receiving any VZV-containing vaccine (primary varicella or zoster)
* History of herpes zoster reactivation within 5 years prior to enrollment
* Received any live vaccine within 6 weeks or inactivated/recombinant vaccine within 2 weeks of enrollment
* Known Hepatitis B, C or HIV virus infection
* History of drug or alcohol abuse within 1 year of screening
* Rituximab therapy within 2 years of screening
* Cyclophosphamide within 6 months of screening
* Biologic therapy (TNF inhibitors, CTLA-4Ig, etc.) within 6 months of screening
* Use of mycophenolate mofetil within 3 months of screening
* History of receiving immunoglobulin or other blood product within 3 months of screening
* Allergic reaction, intolerance or other contraindication to use of famciclovir.
* Has received an experimental/investigational agent (vaccine, drug, biologic, device, blood product, or medication) within 3 months of screening; or expects to receive another experimental/investigational agent within 6 months post immunization.
* Pregnant or lactating women
* Unwilling to use acceptable method of contraception for the duration of the study
* WBC \<3.0; ANC \<1500; CD4+ \<200
* Proteinuria \>1.5 mg/day
* Impaired renal function defined by serum Cr \>1.5
* Transaminases \> 2x upper limit of normal
* Clinical SLEDAI \> 4
* Active lupus nephritis or cerebritis
* History of neoplastic disease within 5 years of screening, except for completely excised non-melanoma cancer of the skin or in-situ carcinoma of the uterine cervix.
* History of any hematological malignancy, current bleeding disorder or taking anticoagulant medication (heparin or warfarin).
* Any condition that would, in the opinion of the site investigator, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol.
* Has a moderate to severe acute illness and/or oral temperature greater or equal to 100.0oF, within 72 hours prior to vaccination (this may result in temporary delay of vaccination).
Minimum Eligible Age

50 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Oklahoma Medical Research Foundation

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Oklahoma Medical Research Foundation

Oklahoma City, Oklahoma, United States

Site Status

Countries

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United States

References

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Guthridge JM, Cogman A, Merrill JT, Macwana S, Bean KM, Powe T, Roberts V, James JA, Chakravarty EF. Herpes zoster vaccination in SLE: a pilot study of immunogenicity. J Rheumatol. 2013 Nov;40(11):1875-80. doi: 10.3899/jrheum.130170. Epub 2013 Sep 15.

Reference Type DERIVED
PMID: 24037550 (View on PubMed)

Other Identifiers

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OMRF 11-45

Identifier Type: -

Identifier Source: org_study_id