Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults

Lal, Himal; Cunningham, Anthony L.; Godeaux, Olivier; Chlíbek, Roman; Díez-Domingo, Javier; Hwang, Shinn‐Jang; Levin, Myron J.; McElhaney, Janet E.; Põder, Airi; Puig-Barberà, Joan; Vesikari, Timo; Watanabe, Daisuke; Weckx, Lily Yin; Zahaf, Toufik; Heineman, Thomas C.

doi:10.1056/nejmoa1501184

Cited by 1,126 publications

(1,007 citation statements)

References 32 publications

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“…Studies revealed that 2 doses of HZ/su containing 50 μg of recombinant VZV glycoprotein E administered at 1-or 2-month intervals were well-tolerated and induced much more robust VZV-specific and VZV glycoprotein E-specific CD4 + T cell and antibody responses than did vOka (55,56). A randomized placebo-controlled study of 15,411 subjects ≥ 50 years of age revealed a remarkable 97.2% efficacy in preventing zoster for a 3.2-year period that did not diminish with increasing age (57). Compared to the placebo group, systemic adverse reactions were 2.2-fold greater in the vaccine group.…”

Section: Gsk Vaccine (Hz/su)mentioning

confidence: 99%

Varicella Zoster Virus: A Common Cause of Stroke in Children and Adults

Amlie‐Lefond

Gilden

2016

Journal of Stroke and Cerebrovascular Diseases

104

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Background-Varicella zoster virus (VZV) is a neurotropic exclusively human herpesvirus. Primary infection causes varicella (chickenpox), after which virus become latent in ganglionic neurons along the entire neuraxis. As cell-mediated immunity to VZV declines with advancing age and immunosuppression, VZV reactivates to produce zoster (shingles). One of the most serious complications of zoster is VZV vasculopathy.

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Section: Gsk Vaccine (Hz/su)mentioning

confidence: 99%

Varicella Zoster Virus: A Common Cause of Stroke in Children and Adults

Amlie‐Lefond

Gilden

2016

Journal of Stroke and Cerebrovascular Diseases

104

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“…HZ/su consists of 50 µg of recombinant VZV antigen (glycoprotein E) which directs the immune response to the virus itself, combined with the AS01B adjuvant system to stimulate T cell immunity to recombinant proteins [106]. As described in detail elsewhere [106], two very large multicenter-blinded RCTs reported that, among participants who had received two doses of Hz/su, VE against zoster was 97.2% (95% CI 93.7–99.0%) for adults aged ≥50 years [107] and 89.8% (95% CI 84.2–93.7%) for those aged ≥70 years [108]. In a pre-specified analysis of data pooled from both trials, the VE against PHN was 88.8% (95% CI 68.7–97.1%).…”

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

“…While systemic reactions were more commonly reported for the HZ/su vaccine than Zostavax (66.1% [107] versus 24.7% [79]), these adverse effects were transient and around 95% of participants receiving HZ/su in both trials received both vaccine doses. Reassuringly, serious adverse events, immune-mediated diseases and deaths across the entire study period were reported equally between the vaccinated and placebo groups in both ZOE trials.…”

Section: Newer Developments In Zoster Vaccinesmentioning

confidence: 99%

Varicella and herpes zoster vaccine development: lessons learned

Warren‐Gash

Forbes

Breuer

2017

Expert Review of Vaccines

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Introduction: Before vaccination, varicella zoster virus (VZV), which is endemic worldwide, led to almost universal infection. This neurotropic virus persists lifelong by establishing latency in sensory ganglia, where its reactivation is controlled by VZV-specific T-cell immunity. Lifetime risk of VZV reactivation (zoster) is around 30%. Vaccine development was galvanised by the economic and societal burden of VZV, including debilitating zoster complications that largely affect older individuals. Areas covered: We describe the story of development, licensing and implementation of live attenuated vaccines against varicella and zoster. We consider the complex backdrop of VZV virology, pathogenesis and immune responses in the absence of suitable animal models and examine the changing epidemiology of VZV disease. We review the vaccines’ efficacy, safety, effectiveness and coverage using evidence from trials, observational studies from large routine health datasets and clinical post-marketing surveillance studies and outline newer developments in subunit and inactivated vaccines. Expert commentary: Safe and effective, varicella and zoster vaccines have already made major inroads into reducing the burden of VZV disease globally. As these live vaccines have the potential to reactivate and cause clinical disease, developing alternatives that do not establish latency is an attractive prospect but will require better understanding of latency mechanisms.

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“…The role of zoster vaccination in the very old (>85 years) and immunosuppressed population is as yet unclear. However, some of these problems may be solved by the recent development of a new liposome-based subunit vaccine developed by GlaxoSmithKline [23].…”

Section: Phnmentioning

confidence: 99%

Issues in the Treatment of Neurological Conditions Caused by Reactivation of Varicella Zoster Virus (VZV)

Kennedy

2016

Neurotherapeutics

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Varicella zoster virus (VZV) is a ubiquitous neurotropic human herpesvirus. Primary infection usually causes varicella (chicken pox), after which virus becomes latent in ganglia along the entire neuraxis. Decades later, virus reactivates to produce herpes zoster (shingles), a painful dermatomally distributed vesicular eruption. Zoster may be further complicated by postherpetic neuralgia, VZV vasculopathy, myelitis, and segmental motor weakness. VZV reactivation has also been associated with giant cell arteritis. This overview discusses treatment of various conditions that often require both corticosteroids and antiviral drugs. Treatment for VZV-associated disease is often based on case reports and small studies rather than largescale clinical trials. Issues that require resolution include the optimal duration of such combined therapy, more effective treatment for postherpetic neuralgia, whether some treatments should be given orally or intravenously, the widening spectrum of zoster sine herpete, and the role of antiviral therapy in giant cell arteritis.

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Efficacy of an Adjuvanted Herpes Zoster Subunit Vaccine in Older Adults

Abstract: ConclusionsThe HZ/su vaccine significantly reduced the risk of herpes zoster in adults who were 50 years of age or older. Vaccine efficacy in adults who were 70 years of age or older was similar to that in the other two age groups. (

Cited by 1,126 publications

References 32 publications

Varicella Zoster Virus: A Common Cause of Stroke in Children and Adults

Varicella Zoster Virus: A Common Cause of Stroke in Children and Adults

Varicella and herpes zoster vaccine development: lessons learned

Issues in the Treatment of Neurological Conditions Caused by Reactivation of Varicella Zoster Virus (VZV)

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