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Comparative Study of Two Vaccination Schedules for the Subunit Herpes Zoster Vaccine in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disease Patients Treated With Anti-CD20 Therapy: an Open-label Randomised Controlled Trial (TACTIC)

2026년 9월 7일 업데이트: University Hospital, Toulouse

Immunocompromised individuals, such as patients with multiple sclerosis (MS) or diseases of the neuromyelitis optica spectrum (NMOSD) treated with an anti-CD20 monoclonal antibody, present an increased risk of shingles. The immunogenicity - and therefore the clinical effectiveness - of the recombinant vaccine against the varicella zoster virus based on glycoprotein E, recently recommended according to two-dose schedule two months apart in immunocompromised patients aged ≥ 18 years, could be significantly decreased when administered one month before and one month after the infusion of anti-CD20.

We hypothesize that, in patients with MS or NMOSD treated with anti-CD20 administered every six months, a two-dose M0-M6 vaccination schedule consisting of deferring the second dose six months after the first infusion, that is, five months after the anti-CD20 infusion, could improve vaccine immunogenicity and, consequently, the effectiveness of the vaccine.

연구 개요

상태

아직 모집하지 않음

정황

개입 / 치료

상세 설명

Shingles, caused by reactivation of varicella zoster virus (VZV), is a common condition in immunocompromised people. Its prevention, which has long remained a medical need unmet among these patients, was improved thanks to the availability of the recombinant glycoprotein-based VZV vaccine E (gE). Based on demonstrated clinical efficacy and safety profile in the general population as well as in immunocompromised patients, this vaccine is recommended in France according to a two-person schedule doses spaced two months apart in immunocompromised patients aged ≥ 18 years. However, further studies are needed in order to optimize vaccination strategies according to the different types of immunosuppression.

Patients with MS or NMOSD, who are at increased risk of herpes zoster, are extensively treated with anti-CD20 monoclonal antibodies, which are known to significantly alter immune responses to vaccines, in particular when vaccination is carried out early after the infusion of anti-CD20.

We hypothesize that in patients with MS or NMOSD treated with anti-CD20 administered every six months, a two-dose M0-M6 vaccination schedule, consisting of deferring the second dose to six months after the first, that is, five months after the anti-CD20 infusion, could improve vaccine immunogenicity and, consequently, the effectiveness of the vaccine.

In this phase IV randomized, controlled, open-label, parallel-group trial, we will compare, within a homogeneous population of patients with MS or NMOSD receiving antiCD20, the humoral response induced by a two-dose vaccination schedule administered at 2 months (M0-M2, "2-month" or standard group) or 6 months (M0-M6, "6-month" or experimental group). After the screening and inclusion phase, patients randomized to the M0-M2 (standard) and M0-M6 (experimental) groups will receive a first dose of recombinant herpes zoster vaccine (RZV) one month before the next scheduled infusion of anti-CD20 monoclonal antibodies (M1). The second dose of RZV will be given at either 2 months ("2-month group", M2) or 6 months ("6-month group", M6). Patients will receive their usual anti-CD20 monoclonal antibody infusions at the appropriate time M1, M7 and M13. The primary outcome will be evaluated one month after the second vaccine dose (M3 for the "2 months" group and M7 for the "6 months" group). The kinetics, intensity, and persistence of humoral and cellular immune responses, as well as safety, will be analyzed as criteria for secondary judgments during the scheduled follow-up visits until M13.

연구 유형

중재적

등록 (추정된)

160

단계

  • 4단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 장소

  • 프랑스
      • Besançon, 프랑스, 25 000
        • Jean Minjoz University Hospital
        • 수석 연구원:
          • Eric Berger, MD
        • 연락하다:
      • Bordeaux, 프랑스, 33 000
        • Pellegrin Hospital Group
        • 연락하다:
        • 수석 연구원:
          • Aurélie Ruet, PHD
      • Caen, 프랑스, 14 033
        • Côte de Nacre University Hospital
        • 연락하다:
        • 수석 연구원:
          • Pierre Branger, MD
      • Clermont-Ferrand, 프랑스, 63 000
        • Gabriel Montpied Hospital
        • 연락하다:
        • 수석 연구원:
          • Pierre Clavelou, MD
      • Créteil, 프랑스, 94 000
        • GCS CHIC Henri Mondor
        • 수석 연구원:
          • Alain Creange, PHD
        • 연락하다:
      • Dijon, 프랑스, 21 000
        • Dijon Hospital University
        • 연락하다:
        • 수석 연구원:
          • Thibault Moreau, PHD
      • Grenoble, 프랑스, 38 700
        • Nord Hospital - Grenoble University Hospital
        • 수석 연구원:
          • Olivier Casez, MD
        • 연락하다:
      • Libourne, 프랑스, 33 500
        • Libourne Hospital Center
        • 연락하다:
        • 수석 연구원:
          • Arnaud Gagnol, MD
      • Lille, 프랑스, 59 037
        • Roger Salengro Hospital - Lille University Hospital
        • 연락하다:
        • 수석 연구원:
          • Hélène Zephir, PHD
      • Lille, 프랑스, 59 400
        • Catholics Institut Hospitals Group
        • 연락하다:
        • 수석 연구원:
          • Arnaud Kwiatkowski, PHD
      • Lyon, 프랑스, 69 002
        • Lyon Civil Hospices
        • 연락하다:
        • 수석 연구원:
          • Sandra Vukusic, PHD
      • Montpellier, 프랑스, 34 295
        • Gui de Chauliac Hospital - Montpellier University Hospital
        • 연락하다:
        • 수석 연구원:
          • Xavier Ayrignac, PHD
      • Nantes, 프랑스, 44 800
        • Laennec Hospital
        • 수석 연구원:
          • Sandrine Wiertlewski, MD
        • 연락하다:
      • Nice, 프랑스, 06 000
        • Pasteur Hospital
        • 연락하다:
        • 수석 연구원:
          • Mikael Cohen, PHD
      • Nîmes, 프랑스, 30 900
        • Nîmes University Hospital
        • 연락하다:
        • 수석 연구원:
          • Eric Thouvenot, PHD
      • Paris, 프랑스, 75 012
        • 15/20 Hospital
        • 연락하다:
        • 수석 연구원:
          • Dalia Dimitri-Boulos, MD
      • Paris, 프랑스, 75 013
        • Pitié Salpetrière Hospital
        • 연락하다:
        • 수석 연구원:
          • Céline Louapre, PHD
      • Paris, 프랑스, 75 019
        • Adolphe de Rothschild Hospital
        • 수석 연구원:
          • Marine Boudot de La Motte, MD
        • 연락하다:
      • Poissy, 프랑스, 78 300
        • Intercommunal Hospital Center of Poissy Saint-Germain
        • 수석 연구원:
          • Olivier Heinzlef, MD
        • 연락하다:
      • Poitiers, 프랑스, 86 000
        • La Miletrie University Hospital
        • 연락하다:
        • 수석 연구원:
          • Amélie Dos Santos, MD
      • Rennes, 프랑스, 35 000
        • Pontchaillou Hospital
        • 연락하다:
        • 수석 연구원:
          • Laure Michel, PHD
      • Rouen, 프랑스, 76 000
        • Charles Nicolle Hospital
        • 연락하다:
        • 수석 연구원:
          • Maxime Guillaume, MD
      • Toulouse, 프랑스, 31 300
        • Purpan Hospital
        • 수석 연구원:
          • Jonathan Ciron, MD
        • 연락하다:
      • Tours, 프랑스, 37 000
        • Tours Hospital University
        • 수석 연구원:
          • Inès Doghri, MD
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  • Patients with Multiple Sclerosis (any clinical form) or Neuromyelitis optica spectrum disease seropositive for aquaporin-4 antibodies (AQP4+)
  • Aged 18 years or more
  • Treated with anti-CD20 mAbs (Rituximab IV or Ocrelizumab IV or SC) since < 2 years with dosing intervals of 6 months (and for Rituximab, treated with 1g per infusion)
  • Planned to receive the same anti-CD20 mAbs with dosing intervals of 6 months during the 13 months of the study (and for Rituximab, planned to receive 1g per infusion)
  • Known history in the medical file of varicella, or VZV IgG serology known to evidence a prior infection
  • Affiliated or beneficiary of a social security scheme
  • Written and informed consent
  • Understands and agrees to comply with the study procedures

Exclusion Criteria:

  • Temporary contraindication to vaccination (concurrent episode of acute fever >38.5°C)
  • Shingles in the last 12 months or VZV vaccination in the last 5 years
  • Patients already treated or supposed to be treated with Ofatumumab (another anti-CD20 mAbs but delivered with a monthly subcutaneous injection)
  • Patients who received high dose corticosteroids (methylprednisolone at a dose of ≥ 500 mg, administered over 1 to 5 days) in the 3 months prior to inclusion
  • Patients who have been exposed to Cladribine in the prior 12 months
  • Patients who received or were scheduled to receive any vaccination, except for influenza and SARS-CoV-2 vaccines during the epidemic season, within 2 weeks prior to the 2 RZV injections and up to 4 weeks after the second RZV injection
  • Hypersensitivity to the active substance or to one of the excipients
  • Patient protected by the law (guardianship, curatorship)
  • Pregnancy or breast-feeding
  • Women of childbearing potential (WOCBP) without effective contraception throughout the duration of the trial
  • Criteria related to the use of ancillary anti-CD20 treatments (Rituximab and Ocrelizumab):

Hypersensitivity to the active substance or to any of the excipients Severe, active infections Severe immunodeficiency Severe heart failure or severe uncontrolled heart disease Known progressive malignancies

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
활성 비교기: 2 months arm
Patients will receive the standard vaccination schedule in two doses in 2 months.
생물학적: Two-dose M0-M2 vaccination schedule

Patients randomized to the "2 months" vaccination group will receive their first dose of RZV vaccine one month before the next scheduled infusion anti-CD20 monoclonal antibody (M0 corresponding to the visit during the first dose of vaccine, M1 at the time of scheduled anti-CD20 infusion).

The second dose of RZV vaccine will be administered 2 months later. Patients will receive their regular anti-CD20 infusions at times M1, M7, and M13.
실험적: 6 months arm
Patients will receive a vaccination schedule in two doses in 6 months.
생물학적: Two-dose M0-M6 vaccination schedule

Patients randomized to the "6 months" vaccination group will receive their first dose of RZV vaccine one month before the next scheduled infusion anti-CD20 monoclonal antibody (M0 corresponding to the visit during the first dose of vaccine, M1 at the time of scheduled anti-CD20 infusion).

The second dose of RZV vaccine will be administered 6 months later. Patients will receive their regular anti-CD20 infusions at times M1, M7, and M13.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Humoral vaccine response rate for IgG anti-VZV gE response
기간: 3 months for the " 2 months " group and 7 months for the " 6 months " group
It will be defined as the proportion of patients with at least a 4-fold increase in anti-VZV gE antibody titers (measured by ELISA) at 1 month after the 2nd vaccine dose compared to baseline (M0), or seroconversion for those who were seronegative at M0.
3 months for the " 2 months " group and 7 months for the " 6 months " group

2차 결과 측정

결과 측정
측정값 설명
기간
The humoral response in terms of Geometric Mean Titer (GMT) at 1 month after the 2nd vaccine dose.
기간: 3 months for the " 2 months " group and 7 months for the " 6 months " group

It will be assessed by the ratio (M0-M6 versus M0-M2 groups) of the adjusted Geometric Mean Titer (GMT) of anti-VZV gE IgG at 1 month after the 2nd vaccine dose.

The adjusted GMT will correspond to the GMT at 1 month after the 2nd vaccine dose conditionally to the means of the log transformed GMT before vaccination at baseline (M0) calculated across the treatment groups.
3 months for the " 2 months " group and 7 months for the " 6 months " group
Composite criteria of the humoral response up to M13
기간: 13 months
The kinetics, intensity and persistance will be assessed by the Geometric Mean Titer (GMT) of anti-VZV gE IgG measured at baseline (M0) and up to M13: before the 2nd vaccine dose, 1 month after the 2nd vaccine dose, and prior to the next anti CD20 infusions at M7 and M13.
13 months
Composite criteria of the cellular response at 1 month after the 2nd vaccine dose
기간: 3 months for the " 2 months " group and 7 months for the " 6 months " group

It will be assessed by the cellular vaccine response rate for gE-specific CD4[AIM+] T response measured 1 month after the 2nd vaccine dose.

The cellular VRR is defined as the proportion of patients with a proportion of gE-specific CD4[AIM+] T cells at least 2 times above the cutoff after vaccination.

The proportion of gE-specific CD4[AIM+] T cells among CD4 T cells is defined by the proportion of CD4 T cells expressing at least one Activation-Induced Marker (AIM), as detected by flow cytometry, following in vitro stimulation with a peptide pool covering the entire ectodomain of gE. The AIM include CD69, CD25, OX40, CD40L, and CD137. We will determine the cut-off of gE-specific CD4[AIM+] T cells by assessing cellular immune responses across a range of non-vaccinated, healthy individuals.
3 months for the " 2 months " group and 7 months for the " 6 months " group
Composite criteria of the cellular response at M13
기간: 13 months
The kinetics, intensity and persistance of the cellular response up to M13 will be assessed by the proportion of gE-specific CD4[AIM+] T cells among CD4 T cells measured at baseline (M0) and up to M13 : before the 2nd vaccine dose, 1 month after the 2nd vaccine dose, and prior to the next anti-CD20 infusions at M7 and M13.
13 months
The vaccine safety
기간: from M0 to month 13
The safety will be assessed by the adverse events including serious adverse events collected during the study.
from M0 to month 13

기타 결과 측정

결과 측정
측정값 설명
기간
Composite criteria of the predicted humoral response at M20
기간: 20 months

Predicted humoral vaccine response rate will be assessed by the predicted humoral vaccine response rates at M20 of the M0-M6 RZV vaccine schedule ("6 months" group) and the M0-M2 RZV vaccine schedule ("2 months" group).

Anti-VZV gE IgG at M20 will be assessed by the adjusted Geometric Mean Titers of anti-VZV gE IgG at M20 of the M0-M6 RZV vaccine schedule ("6 months" group) and the M0-M2 RZV vaccine schedule ("2 months" group).
20 months
The overall predicted humoral exposure from M0 to M20
기간: 20 months
It will be assessed by the areas under the curve (AUC) of anti-VZV gE IgG titers between M0 and M20 of the M0-M6 RZV vaccine schedule ("6 months" group) and the M0-M2 RZV vaccine schedule ("2 months" group).
20 months
The predicted cellular response at M20
기간: 20 months
It will be assessed by the predicted cellular vaccine rate response proportions of gE specific CD4[AIM+] T cells among CD4 T cells of the M0-M6 RZV vaccine schedule ("6 months" group) and the M0-M2 RZV vaccine schedule ("2 months" group).
20 months
The overall predicted cellular exposure from M0 to M20
기간: 20 months
It will be assessed by the areas under the curve (AUC) of gE-specific CD4[AIM+] T cells among CD4 T cells between M0 and M20 of the M0-M6 RZV vaccine schedule ("6 months" group) and the M0-M2 RZV vaccine schedule ("2 months" group).
20 months
Composite criteria of the associated factors with early and persistent, humoral and cellular vaccine responses
기간: 20 months
The factors which will be studied are : age, sex, number of prior anti-CD20 infusions, type of latest DMT before anti-CD20 therapy, albumin and gammaglobulin levels, Ig G levels, leukocyte counts, T and B cell immunophenotyping, and immune exhaustion and immunosenescence markers throughout the study.
20 months
The correlation between the titers of anti-VZV gE IgG by ELISA and the titers of total IgG anti-VZV by the commercial Diasorin serological test.
기간: 20 months
It will be assessed by the correlation between ELISA gE titer and the total anti-VZV glycoproteins IgG measured by the Liaison XL® Diasorin serological test.
20 months

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

University Hospital, Toulouse

수사관

  • 수석 연구원: Jonathan Ciron, MD, University Hospital, Toulouse

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 10월 20일

기본 완료 (추정된)

2030년 6월 20일

연구 완료 (추정된)

2030년 11월 30일

연구 등록 날짜

최초 제출

2026년 9월 7일

QC 기준을 충족하는 최초 제출

2026년 9월 7일

처음 게시됨 (실제)

2026년 9월 14일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 9월 14일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 9월 7일

마지막으로 확인됨

2026년 9월 1일

추가 정보

이 연구와 관련된 용어

키워드

추가 관련 MeSH 약관

기타 연구 ID 번호

  • RC31/25/0535
  • 2025 (미국 NIH 보조금/계약: Faculty of Social Sciences Scientific Grant at the University of Gdańsk)
  • PHRC 24-0185 (기타 보조금/기금 번호: French Ministry of Health)
  • 2025-525106-37-00 (기타 식별자: ID-RCB)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

미정

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

구독하다