Quality of Life Impact of an Adjuvanted Recombinant Zoster Vaccine in Adults Aged 50 Years and Older

Desmond Curran, Lidia Oostvogels, Thomas Heineman, Sean Matthews, Janet McElhaney, Shelly McNeil, Javier Diez-Domingo, Himal Lal, Charles Andrews, Eugene Athan, Johan Berglund, Laura Campora, Ferdinandus de Looze, Tiina Korhonen, Edward Leung, Myron Levin, Antonio Volpi, Robert W Johnson, ZOE-50/70 Study Group, Desmond Curran, Lidia Oostvogels, Thomas Heineman, Sean Matthews, Janet McElhaney, Shelly McNeil, Javier Diez-Domingo, Himal Lal, Charles Andrews, Eugene Athan, Johan Berglund, Laura Campora, Ferdinandus de Looze, Tiina Korhonen, Edward Leung, Myron Levin, Antonio Volpi, Robert W Johnson, ZOE-50/70 Study Group

Abstract

Background: To determine the efficacy of an adjuvanted recombinant zoster vaccine in reducing the herpes zoster (HZ) burden of illness, HZ burden of interference with activities of daily living, and HZ impact on quality of life.

Methods: The assessments were integrated in two Phase III trials, ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229). HZ burden of illness and HZ burden of interference with activities of daily living were assessed by the Zoster Brief Pain Inventory (ZBPI) instrument and quality of life by the EuroQol-5 Dimension (EQ-5D) utility index and the SF-36 health survey. We report the ZOE-50 results and a pooled analysis of patients aged 70 years and older from the trials combined.

Results: The estimated vaccine efficacy in reducing HZ burden of illness and HZ burden of interference was greater than 90% in both the ZOE-50 and the pooled ZOE-70 analysis. In confirmed HZ cases, adjuvanted recombinant zoster vaccine reduced the maximal ZBPI worst-pain score in the pooled ZOE-70 analysis (p = .032) and the maximal ZBPI average-pain scores in both the ZOE-50 (p = .049) and the pooled ZOE-70 analysis (p = .043). In breakthrough HZ cases, trends for diminished loss of quality of life compared with placebo-recipient HZ cases were observed, with differences up to 0.14 on the EQ-5D index at time points during the 4 weeks following HZ onset.

Conclusions: Adjuvanted recombinant zoster vaccine reduced the HZ burden of illness significantly, particularly due to its very high vaccine efficacy in preventing HZ. For breakthrough HZ cases, the results suggest that the adjuvanted recombinant zoster vaccine mitigated severity of HZ-related pain, burden of interference with activities of daily living, and recipients' utility loss.

Keywords: Activities of daily living; Burden of illness; Burden of interference.

© The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America.

Figures

Figure 1.
Figure 1.
Mean ZBPI “worst-pain” scores per day during the first 28 days after rash onset (A: ZOE-50 study; B: pooled ZOE-70 analysis). RZV = adjuvanted recombinant zoster vaccine; ZBPI = Zoster Brief Pain Inventory. *Days with statistically significant differences (at the .05 level) in ZBPI worst-pain scores between the two groups. In the ZOE-50 study, no RZV recipient with HZ completed the ZBPI days 0 and 1.
Figure 2.
Figure 2.
Mean daily ZBPI ADL scores during the first 28 days after rash onset for the placebo groups (A: ZOE-50 study; B: pooled ZOE-70 analysis). ADL = activities of daily living; ZBPI = Zoster Brief Pain Inventory.
Figure 3.
Figure 3.
Mean EQ-5D utility scores during the first 28 days after rash onset (A: ZOE-50 study; B: pooled ZOE-70 analysis). CI = confidence interval; Diff. = difference; EQ-5D = EuroQol-5 Dimension; RZV = adjuvanted recombinant zoster vaccine.

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Source: PubMed

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