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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)

2026年9月7日 更新者：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.

研究概览

地位

尚未招聘

条件

干预/治疗

详细说明

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.

研究类型

介入性

注册 (估计的)

160

阶段

  • 第四阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

学习地点

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

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

  • 成人
  • 年长者

接受健康志愿者

不

描述

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

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
有源比较器：2 months arm
Patients will receive the standard vaccination schedule in two doses in 2 months.
生物：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.
实验性的：6 months arm
Patients will receive a vaccination schedule in two doses in 6 months.
生物：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.

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Humoral vaccine response rate for IgG anti-VZV gE response
大体时间：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

次要结果测量

结果测量
措施说明
大体时间
The humoral response in terms of Geometric Mean Titer (GMT) at 1 month after the 2nd vaccine dose.
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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

其他结果措施

结果测量
措施说明
大体时间
Composite criteria of the predicted humoral response at M20
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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.
大体时间：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

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

University Hospital, Toulouse

调查人员

  • 首席研究员：Jonathan Ciron, MD、University Hospital, Toulouse

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (估计的)

2026年10月20日

初级完成 (估计的)

2030年6月20日

研究完成 (估计的)

2030年11月30日

研究注册日期

首次提交

2026年9月7日

首先提交符合 QC 标准的

2026年9月7日

首次发布 (实际的)

2026年9月14日

研究记录更新

最后更新发布 (实际的)

2026年9月14日

上次提交的符合 QC 标准的更新

2026年9月7日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • RC31/25/0535
  • 2025 (美国 NIH 拨款/合同：Faculty of Social Sciences Scientific Grant at the University of Gdańsk)
  • PHRC 24-0185 (其他赠款/资助编号：French Ministry of Health)
  • 2025-525106-37-00 (其他标识符：ID-RCB)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

未定

药物和器械信息、研究文件

研究美国 FDA 监管的药品

不

研究美国 FDA 监管的设备产品

不

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