Recurrent Respiratory Papillomatosis (RRP)—Meta-analyses on the use of the HPV vaccine as adjuvant therapy

Goon, Peter; Sauzet, Odile; Schuermann, Matthias; Oppel, F.; Shao, Senyao; Scholtz, Lars‐Uwe; Sudhoff, Holger; Göerner, Martin

doi:10.1038/s41541-023-00644-8

Cited by 9 publications

(4 citation statements)

References 36 publications

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“…, reported an increase in intersurgical intervals following vaccination with Gardasil ® , thereby highlighting the benefit of Gardasil ® as adjuvant therapy in JoRRP. 12,13 Our study showed a minor overall increase in intersurgical time intervals; the most significant increase was observed in the patients with more severe disease, with an average of 2.8 to 9 months intersurgical intervals following three doses of the Gardasil ® . In addition, 16/25 patients (64%) received at least one dose of Gardasil ® in their 1st year of the disease, with many patients showing an improvement in their DC scores in their first year.…”

Section: Discussionmentioning

confidence: 64%

Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town

Frank,

McGuire,

Kabagenyi

et al. 2024

Journal of the Colleges of Medicine of South Africa

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Background: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is an incurable condition caused by human papilloma virus (HPV) types 6 and 11, often requiring repeated surgeries and in severe cases, tracheostomy. This imposes a significant socioeconomic burden on patients and families. Gardasil®, a proven prophylactic HPV vaccine, is emerging as a potential adjuvant therapy. We studied its response on JoRRP patients at our center.Methods: We conducted a retrospective review at Red Cross War Memorial Children’s Hospital from January 2015 to June 2022 on histologically confirmed JoRRP cases. Age at diagnosis, baseline and post-dosing Derkay-Coltrera (DC) scores (disease severity measure), inter-surgical intervals and tracheostomy, were collected.Results: Twenty-five of 30 confirmed cases were included. Average age at diagnosis was 60 months (about 5 years old), with HPV Type 6 in 40% and Type 11 in 48% of patients. All patients received at least one Gardasil® dose, 84% received a second dose and 64% a third dose. Total population DC score decreased from an average of 17 (range: 4-34) pre-first dose to 8 (range: 0-16) after three doses, indicating a 50% reduction. Surgical intervals modestly increased. More significant improvements were seen in patients with aggressive forms of the disease.Conclusion: This is the first study in Southern Africa highlighting Gardasil® as adjuvant therapy. Despite our limited sample size, new cases observed a linear reduction in DC scores and tracheostomy rates.Contribution: This suggests that Gardasil® as adjuvant therapy has the potential to reduce disease severity and extend surgical intervals.

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Section: Discussionmentioning

confidence: 64%

Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town

Frank,

McGuire,

Kabagenyi

et al. 2024

Journal of the Colleges of Medicine of South Africa

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“…Moreover, the reduction of recurrences after treatment in vaccinated patients is also confirmed for benign lesions [111][112]. In fact, for respiratory papillomatosis the substantial benefit is known for HPV vaccination used as adjunctive therapy in combination with surgery [113]. In contrast, vaccination does not seem to provide a significantly secondary benefit in patients with previous ano-genital warts, also this cannot be generalized due to the few randomized controlled trials performed [114].…”

Section: Tertiary Preventionmentioning

confidence: 99%

Human Papillomavirus Epidemiology and Prevention: Is There Still a Gender Gap?

Milano¹,

Guarducci²,

Nante³

et al. 2023

Preprint

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Background and aim: Human Papillomavirus (HPV) is sexually transmitted, one of the three most common sexually transmitted infections (STIs) in both males and females, and the most common viral STI. A crucial public health strategy to protect people against HPV is through vaccination, which has shown its effectiveness in preventing HPV related diseases. Presently three types of vaccines are available (bivalent, quadrivalent, and nonavalent) and they all target at least the two most oncogenic virus genotypes (HPV 16, 18). In the past few years, the need to implement vaccination programmes that include all genders has been discussed in order to achieve herd immunity against HPV. To date, only a few countries have included young males in their vaccination programmes, so we aim through this review to provide an overview of the epidemiology of HPV and prevention strategies to prevent it, reporting the latest findings from the scientific literature.

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“…In a non-randomised trial, patients with newly diagnosed or established RRP were vaccinated, and both groups showed a reduced frequency of RRP and a reduced disease burden [ 79 ]. A meta-analysis of HPV vaccination in RRP cases alongside surgery indicated that vaccination is a beneficial adjunct therapy alongside surgery [ 80 ]. Treatment with GARDASIL9 ® has positively affected five cases of recalcitrant genital warts [ 81 ].…”

Section: Hpv Vaccination Of People With Hpv-associated Diseasementioning

confidence: 99%

Recent Developments in Human Papillomavirus (HPV) Vaccinology

Williamson

2023

Viruses

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Human papillomavirus (HPV) is causally associated with 5% of cancers, including cancers of the cervix, penis, vulva, vagina, anus and oropharynx. The most carcinogenic HPV is HPV-16, which dominates the types causing cancer. There is also sufficient evidence that HPV types 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59 cause cervical cancer. The L1 protein, which, when assembled into virus-like particles, induces HPV-type-specific neutralising antibodies, forms the basis of all commercial HPV vaccines. There are six licensed prophylactic HPV vaccines: three bivalent, two quadrivalent and one nonavalent vaccine. The bivalent vaccines protect from HPV types 16 and 18, which are associated with more than 70% of cervical cancers. Prophylactic vaccination targets children before sexual debut, but there are now catch-up campaigns, which have also been shown to be beneficial in reducing HPV infection and disease. HPV vaccination of adults after treatment for cervical lesions or recurrent respiratory papillomatosis has impacted recurrence. Gender-neutral vaccination will improve herd immunity and prevent infection in men and women. HPV vaccines are immunogenic in people living with HIV, but more research is needed on the long-term impact of vaccination and to determine whether further boosters are required.

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Recurrent Respiratory Papillomatosis (RRP)—Meta-analyses on the use of the HPV vaccine as adjuvant therapy

Cited by 9 publications

References 36 publications

Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town

Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town

Human Papillomavirus Epidemiology and Prevention: Is There Still a Gender Gap?

Recent Developments in Human Papillomavirus (HPV) Vaccinology

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