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Zostavax in Systemic Lupus Erythematosus

Information source: Oklahoma Medical Research Foundation
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Systemic Lupus Erythematosus

Intervention: Zostavax vaccine (Drug)

Phase: Phase 1

Status: Completed

Sponsored by: Oklahoma Medical Research Foundation

Summary

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.

Clinical Details

Official title: Immunologic Response to Varicella Zoster Vaccination With Zostavax in Patients With Systemic Lupus Erythematosus

Study design: Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Primary outcome: Cell-mediated immune response to varicella at 12 weeks following vaccination

Secondary outcome:

Antibody response to Zostavax vaccination

Adverse events

Eligibility

Minimum age: 50 Years. Maximum age: 75 Years. Gender(s): Both.

Criteria:

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).

Locations and Contacts

Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma 73104, United States
Additional Information

Starting date: November 2011
Last updated: September 16, 2013

Page last updated: August 23, 2015

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