Combined Pneumococcal Conjugate and Polysaccharide Vaccination in Inflammatory Rheumatic Disease

NCT ID: NCT03762824

Last Updated: 2023-03-29

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

PHASE4

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-14

Study Completion Date

2020-12-21

Brief Summary

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The overall objective of this project is to study the influence of modern anti-inflammatory treatments in established inflammatory rheumatic diseases (IRD) on antibody response elicited by pneumococcal vaccination using 13-valent conjugate vaccine in combined schedules with 23-valent polysaccharide vaccine. In addition, the aim is to study the clinical aspects of vaccination regarding: tolerability in immunosuppressed patients with IRD, impact on existing rheumatic disease, possible association with onset of new autoimmune diseases, long-term immunity following pneumococcal vaccination and efficacy in preventing invasive pneumococcal disease. Results from this study are expected to bridge the existing knowledge gap and contribute to body of evidence needed for recommendations and implementation of vaccination program in IRD patients.

Detailed Description

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Conditions

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Rheumatoid Arthritis Systemic Lupus Sjögren Syndrome Systemic Vasculitis Spondyloarthritis

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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PCV13+PPV23 vaccinated patients

Patients with different inflammatory rheumatic diseases are immunized with one dose 13-valent pneumococcal conjugate vaccine 0.5 ml i.m., followed by one dose 23-valent pneumococcal polysaccharide vaccine 0.5 ml i.m. after 8 weeks.

Group Type ACTIVE_COMPARATOR

13-valent pneumococcal conjugate vaccine

Intervention Type BIOLOGICAL

Pneumococcal conjugate vaccination during antirheumatic treatment

23-valent pneumococcal polysaccharide vaccine

Intervention Type BIOLOGICAL

Pneumococcal polysaccharide vaccination during antirheumatic treatment

PCV13+PPV23 vaccinated controls

Healthy controls are immunized with one dose 13-valent pneumococcal conjugate vaccine 0.5 ml i.m., followed by one dose 23-valent pneumococcal polysaccharide vaccine 0.5 ml i.m. after 8 weeks.

Group Type ACTIVE_COMPARATOR

13-valent pneumococcal conjugate vaccine

Intervention Type BIOLOGICAL

Pneumococcal conjugate vaccination during antirheumatic treatment

23-valent pneumococcal polysaccharide vaccine

Intervention Type BIOLOGICAL

Pneumococcal polysaccharide vaccination during antirheumatic treatment

PPV23-booster to previous PCV-vaccinated patients

Patients with different inflammatory rheumatic disease previously immunized with one dose PCV7 or PCV13 within another study (see VACCIMIL), are immunized with one dose PPV23 0.5 ml i.m.

Group Type ACTIVE_COMPARATOR

23-valent pneumococcal polysaccharide vaccine

Intervention Type BIOLOGICAL

Pneumococcal polysaccharide vaccination during antirheumatic treatment

PCV13 to previous PPV23-vaccinated patients

Patients with different inflammatory rheumatic disease previously immunized with one dose PPV23 within another study (see VACCIMIL), are immunized with one dose PCV13 0.5 ml i.m.

Group Type ACTIVE_COMPARATOR

13-valent pneumococcal conjugate vaccine

Intervention Type BIOLOGICAL

Pneumococcal conjugate vaccination during antirheumatic treatment

PPV23-booster to previous PCV-vaccinated controls

Healthy controls previously immunized with one dose PCV7 or PCV13 within another study (see VACCIMIL), are immunized with one dose PPV23 0.5 ml i.m.

Group Type ACTIVE_COMPARATOR

23-valent pneumococcal polysaccharide vaccine

Intervention Type BIOLOGICAL

Pneumococcal polysaccharide vaccination during antirheumatic treatment

Interventions

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13-valent pneumococcal conjugate vaccine

Pneumococcal conjugate vaccination during antirheumatic treatment

Intervention Type BIOLOGICAL

23-valent pneumococcal polysaccharide vaccine

Pneumococcal polysaccharide vaccination during antirheumatic treatment

Intervention Type BIOLOGICAL

Other Intervention Names

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Prevenar 13 PCV13 Pneumovax PPV23

Eligibility Criteria

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Inclusion Criteria

* Adult patients with IRD receiving active anti-rheumatic treatments with DMARDs or biological remedies are offered to participate in the study. The protocol permits stratification for prednisolone usage.

Exclusion Criteria

* known allergy/intolerance of pneumococcal vaccine
* pregnancy
* active infection
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Region Skane

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jehns Martineus, MD

Role: STUDY_DIRECTOR

Skåne Universitets sjukhus, dept of rheumatology

References

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Doran MF, Crowson CS, Pond GR, O'Fallon WM, Gabriel SE. Frequency of infection in patients with rheumatoid arthritis compared with controls: a population-based study. Arthritis Rheum. 2002 Sep;46(9):2287-93. doi: 10.1002/art.10524.

Reference Type BACKGROUND
PMID: 12355475 (View on PubMed)

Kapetanovic MC, Saxne T, Sjoholm A, Truedsson L, Jonsson G, Geborek P. Influence of methotrexate, TNF blockers and prednisolone on antibody responses to pneumococcal polysaccharide vaccine in patients with rheumatoid arthritis. Rheumatology (Oxford). 2006 Jan;45(1):106-11. doi: 10.1093/rheumatology/kei193. Epub 2005 Nov 15.

Reference Type BACKGROUND
PMID: 16287919 (View on PubMed)

Kapetanovic MC, Roseman C, Jonsson G, Truedsson L, Saxne T, Geborek P. Antibody response is reduced following vaccination with 7-valent conjugate pneumococcal vaccine in adult methotrexate-treated patients with established arthritis, but not those treated with tumor necrosis factor inhibitors. Arthritis Rheum. 2011 Dec;63(12):3723-32. doi: 10.1002/art.30580.

Reference Type BACKGROUND
PMID: 21834061 (View on PubMed)

Nived P, Nagel J, Saxne T, Geborek P, Jonsson G, Skattum L, Kapetanovic MC. Immune response to pneumococcal conjugate vaccine in patients with systemic vasculitis receiving standard of care therapy. Vaccine. 2017 Jun 22;35(29):3639-3646. doi: 10.1016/j.vaccine.2017.05.044. Epub 2017 May 25.

Reference Type BACKGROUND
PMID: 28552512 (View on PubMed)

Centers for Disease Control and Prevention (CDC). Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine for adults with immunocompromising conditions: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2012 Oct 12;61(40):816-9.

Reference Type BACKGROUND
PMID: 23051612 (View on PubMed)

Nived P, Jonsson G, Settergren B, Einarsson J, Olofsson T, Jorgensen CS, Skattum L, Kapetanovic MC. Prime-boost vaccination strategy enhances immunogenicity compared to single pneumococcal conjugate vaccination in patients receiving conventional DMARDs, to some extent in abatacept but not in rituximab-treated patients. Arthritis Res Ther. 2020 Feb 22;22(1):36. doi: 10.1186/s13075-020-2124-3.

Reference Type DERIVED
PMID: 32087733 (View on PubMed)

Other Identifiers

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IPS-BOOSTER

Identifier Type: -

Identifier Source: org_study_id

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