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Three Doses of Hepatitis A Vaccine in Patients With Immunomodulating Drugs

This study is ongoing, but not recruiting participants.
Information provided by (Responsible Party):
Lars Rombo, Sormland County Council, Sweden Identifier:
First received: October 3, 2011
Last updated: November 17, 2015
Last verified: November 2015

Hepatitis A vaccine is the most frequently used traveler's vaccine, yet data on its ability to induce protective immunity in immunosuppressed travelers are scarce. The investigators assess the hepatitis A virus (HAV) antibody response in patients with rheumatoid arthritis (RA) treated with Tumor Necrosis Factor (TNF) - inhibitors and/or methotrexate (Mtx).

In a previous study, 2 doses were not considered effective and there is therefore need for a study with an additional dose

Condition Intervention Phase
Vaccine Response Impaired
Biological: hepatitis A vaccine
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: Hepatitis A Vaccination in Patients With Rheumatoid Arthritis Treated With TNF-inhibitors and/or Methotrexate

Resource links provided by NLM:

Further study details as provided by Sormland County Council, Sweden:

Primary Outcome Measures:
  • seroconversion after the first dose/doses of hepatitis A vaccine [ Time Frame: one month after the first dose/doses ]
    ELISA-titers are determined before the first dose/doses and at 1 month later

Secondary Outcome Measures:
  • seroconversion rates after three doses of hepatitis A vaccine [ Time Frame: 12 months after the first doses ]
    We determine seroconversion rates before the third vaccine dose (6 months after the first) and at 1 and 6 months after the second dose

Estimated Enrollment: 150
Study Start Date: September 2011
Estimated Study Completion Date: August 2016
Estimated Primary Completion Date: August 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: initial single dose of hep A vaccine
The participants will receive a single dose of hepatitis A vaccine at 0+1+6 months
Biological: hepatitis A vaccine
3 doses of hepatitis A vaccine, given at 0+1+6 months
Active Comparator: initial double dose
Participants will receive one dose of hepatitis A vaccine in each M. deltoids and an additional dose at 6 months later
Biological: hepatitis A vaccine
Two doses of hepatitis A vaccine given at day 0, one in each M deltoids. An additional dose will be given at 6 months later

Detailed Description:
Methods: Parameters registered at baseline were: age, sex, duration of disease, medications, activity of disease (Visual Analogue Scale), Health Assessment Questionnaire Disability Index, Disease Activity Score, Acute phase reactant and total immunoglobulin G in plasma). Hepatitis A vaccine (Epaxal or Havrix) were given at 0 and 6 months. Hepatitis A virus (HAV) antibodies is measured before vaccination and at month 1, 6 (before dose 2), 7 and 12 with quantitative HAV IgG, using the HAVAb-IgG Architect System, and by the HAVAB 2.0 assay on the AxSYM machine from Abbott. The level of protective immunity to HAV is defined as HAV IgG > 10mIU/mL.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Diagnosis of rheumatoid arthritis
  • TNF-alfa blocker and / or methotrexate in use as a medication against RA
  • A desire to get protected against hepatitis A
  • Men and women age 18-65 years
  • Written informed consent
  • Women of childbearing potential must use effective contraception -

Exclusion Criteria:

  • Treatment with rituximab within 9 months before study start
  • Known previous hepatitis A infection
  • Previous vaccination against hepatitis A
  • Allergy to eggs or formaldehyde
  • Pregnancy or lactation
  • Excessive use of alcohol
  • Mental retardation
  • Acute disease at the time of examination (fever > 38 degrees)
  • Volunteer works as an employee of the researchers
  • Previous vaccination against hepatitis A
  • Egg-, hen-protein- or formaldehyde allergy
  • Pregnancy or lactation
  • Excessive use of alcohol
  • Another vaccine given within a month
  • Acute disease at the time of examination (fever > 38 degrees)
  • Not suitable for other reason in the investigator's opinion (other serious disease, i.e. AIDS/HIV-positive, cancer with ongoing cytostatic treatment)
  Contacts and Locations
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Please refer to this study by its identifier: NCT01446978

Dept infectious diseases
Eskilstuna, Sweden, 631 88
Department of infectious diseases
Stockholm, Sweden, 17176
Dept infectious diseases
Uppsala, Sweden, 75185
Dept infectious diseases
Örebro, Sweden, 70185
Sponsors and Collaborators
Sormland County Council, Sweden
Principal Investigator: lars rombo, MD Karolinska Institutet
  More Information

Responsible Party: Lars Rombo, Professor, Sormland County Council, Sweden Identifier: NCT01446978     History of Changes
Other Study ID Numbers: Rombo - 2
Study First Received: October 3, 2011
Last Updated: November 17, 2015

Keywords provided by Sormland County Council, Sweden:
hepatitis A vaccine
TNF-alfa inhibitory drugs
Rheumatoid arthritis

Additional relevant MeSH terms:
Hepatitis A
Liver Diseases
Digestive System Diseases
Hepatitis, Viral, Human
Virus Diseases
Enterovirus Infections
Picornaviridae Infections
RNA Virus Infections
Immunologic Factors
Physiological Effects of Drugs
Abortifacient Agents, Nonsteroidal
Abortifacient Agents
Reproductive Control Agents
Antimetabolites, Antineoplastic
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Dermatologic Agents
Enzyme Inhibitors
Folic Acid Antagonists
Immunosuppressive Agents
Antirheumatic Agents
Nucleic Acid Synthesis Inhibitors processed this record on April 28, 2017