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Evaluation of the Safety of Varivax® in Pediatric Renal Transplant Recipients

This study has been terminated.
(Slow enrollment)
Sponsor:
Collaborators:
Merck Sharp & Dohme Corp.
Cooperative Clinical Trials in Pediatric Transplantation
North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS)
NIAID Vaccine and Treatment Evaluation Units (VTEUs)
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT00005009
First received: March 28, 2000
Last updated: February 14, 2017
Last verified: February 2017
  Purpose

The purpose of this study is to find out whether Varivax is safe for use in children with kidney transplants and whether it protects children from serious infection. Varivax is a vaccine against varicella zoster virus (VZV), the virus that causes chickenpox (varicella) and shingles (zoster).

Healthy children are already receiving Varivax shots to protect them from chickenpox. Few children with kidney transplants have received Varivax because doctors have been concerned that Varivax might cause serious reactions in them. On the other hand, VZV infection can be a life-threatening disease in these children. For this reason, doctors ultimately want to learn whether Varivax might safely prevent VZV infections in children who have had kidney transplants.


Condition Intervention Phase
Kidney Transplant Recipients Biological: Varivax® Phase 1

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: No masking
Primary Purpose: Prevention
Official Title: Evaluation of the Safety and Immunogenicity of Varivax® (Live-Attenuated Varicella-Zoster Virus Vaccine) in Pediatric Renal Transplant Recipients

Resource links provided by NLM:


Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:
  • Immediate adverse reactions [ Time Frame: 30 minutes post vaccination ]
  • Varicella related adverse reactions [ Time Frame: 1 year ]
    1. Fever and local (<1 inch from inoculation site) lesions
    2. Fever and lesions outside the 1 inch inoculation site
    3. Lesions outside the 1 inch inoculation site
    4. Clinical signs of pneumonitis
    5. Clinical or chemical signs of hepatitis
    6. Development of thrombocytopenia

  • Rejection events [ Time Frame: 1 year ]
    1. Increase in creatinine
    2. Renal biopsy


Enrollment: 7
Study Start Date: February 1998
Study Completion Date: June 16, 2001
Primary Completion Date: June 16, 2001 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Varivax®
0.5 mL of Varivax administered subcutaneously in the right upper arm (deltoid region).
Biological: Varivax®
Each participant will receive 2 doses of Varivax 6 to 8 weeks apart.
Other Names:
  • live-attenuated varicella zoster virus vaccine
  • varicella zoster virus vaccine
  • Oka-Merck live virus vaccine

Detailed Description:

Pediatric renal transplant patients face a lifetime of immunosuppressive therapy that place them at high risk for potentially life-threatening infection by primary varicella zoster virus (VZV). Treatment for acute episodes of VZV infection is possible but expensive and provides no long-term protection. Furthermore, therapy to overcome VZV infections can lead to renal graft rejection.

Varivax has proven safe, immunogenic, and effective in the normal host and has been recommended for universal administration in the general population at age 12 months. It is not currently labeled for use in immunocompromised patients. However, recent studies in pediatric leukemia and pediatric renal transplant patients suggest that attenuated live vaccine can confer protection with minimal adverse events even in the presence of immunosuppression, providing encouragement for more careful studies of VZV immunization in renal transplant patients. This study aims to quantify the safety and immunogenicity of Varivax in the population of pediatric renal transplant patients least susceptible to VZV infection, i.e., those on minimal maintenance immunosuppression and at least 1 year out from transplant.

Patient enrollment is staged to allow study physicians to closely monitor patients for signs of disseminated varicella reactions or graft rejection. Initially only 1 patient will be enrolled in the study. If the first patient reaches Week 8 without a severe adverse reaction, 3 study centers will then enroll 3 additional patients. If 8 weeks later these 3 patients have had no severe adverse reactions, the same 3 study centers will enroll 3 more patients. At the end of this period, having ascertained the safety of the vaccine in the first 7 patients, the study will be opened to the remaining centers. Patients receive 2 doses of Varivax 6 to 8 weeks apart. Each week for 6 to 8 weeks after the first vaccine dose, the patient undergoes venipuncture and clinical assessment to characterize renal graft and liver function and identify any signs of varicella infection. Additional telephone follow-up occurs on Day 4 and twice weekly thereafter. Parents or guardians monitor the patient for evidence of rash or fever and immediately report any rashes or fevers to study physicians. If, after 6 to 8 weeks, the patient demonstrates no severe reactions to the vaccine and requires no antiviral therapy, the patient receives the second vaccine dose. The patient again receives weekly on-site and telephone follow-up for 6 weeks. Other visits occur 9 weeks and 14 weeks after the second vaccine dose and 1 year after the first vaccine dose. At these visits the patient undergoes venipuncture and clinical assessment to identify potential rejection events or varicella infection and to characterize VZV antibody responses and cytokine changes in response to the vaccine.

  Eligibility

Ages Eligible for Study:   2 Years to 21 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Your child may be eligible for this trial if he/she:

  • Had a kidney transplant 1 year ago or more;
  • Is between 2 and 21 years of age (parent or guardian's signed informed consent required if under 18);
  • Is taking stable, maintenance doses of immunosuppressive drugs for his/her kidney transplant; and
  • Is generally in good health.

Exclusion Criteria:

Your child will not be eligible for this trial if he/she:

  • Has had any rejection episodes in the last 6 months or has other problems with their kidneys;
  • Was in the hospital for a major infection in the last 30 days;
  • Has a history of VZV infection, including chicken pox or shingles;
  • Has ever received a VZV vaccine, including Varivax®;
  • Lives with a person whose immune system does not work well;
  • Is allergic to certain medications;
  • Is unable to return for the prescribed follow-up check-ups;
  • Has no phone or pager; or
  • Has had blood or plasma transfusions or taken certain drugs in the last 6 months.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00005009

Locations
United States, Alabama
University of Alabama at Birmingham - Vaccine and Treatment Evaluation Unit (VTEU)
Birmingham, Alabama, United States, 35401
United States, Massachusetts
Boston Children's Hospital - Vaccine and Treatment Evaluation Unit (VTEU)
Boston, Massachusetts, United States, 02115
United States, Michigan
University of Michigan - Vaccine and Treatment Evaluation Unit (VTEU)
Ann Arbor, Michigan, United States, 48103
United States, Texas
University of Texas Health Science Center at San Antonio - Vaccine and Treatment Evaluation Unit (VTEU)
San Antonio, Texas, United States, 78229
Sponsors and Collaborators
National Institute of Allergy and Infectious Diseases (NIAID)
Merck Sharp & Dohme Corp.
Cooperative Clinical Trials in Pediatric Transplantation
North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS)
NIAID Vaccine and Treatment Evaluation Units (VTEUs)
Investigators
Study Chair: Amir Tejani, MD North American Pediatric Renal Transplantation Study (NAPRTCS)
Study Chair: Beverly L. Connelly, MD Vaccine and Treatment Evaluation Unit (VTEU)-Cincinnati Children's
  More Information

Additional Information:
Study Data/Documents: Individual Participant Data Set  This link exits the ClinicalTrials.gov site
Identifier: SDY357
ImmPort study identifier is SDY357.
Study Protocol  This link exits the ClinicalTrials.gov site
Identifier: SDY357
ImmPort study identifier is SDY357
Study summary, -design, -demographics, -lab tests, -study files  This link exits the ClinicalTrials.gov site
Identifier: SDY357
ImmPort study identifier is SDY357

Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT00005009     History of Changes
Other Study ID Numbers: DAIT VZV
Study First Received: March 28, 2000
Last Updated: February 14, 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Participant level data and additional relevant materials are available to the public in the Immunology Database and Analysis Portal (ImmPort). ImmPort is a long-term archive of clinical and mechanistic data from DAIT-funded grants and contracts.

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
pediatric renal transplant recipients
varicella zoster virus (VZV) vaccine
herpes zoster vaccine
VZV susceptible
safety
immunogenicity

Additional relevant MeSH terms:
Herpes Zoster
Herpesviridae Infections
DNA Virus Infections
Virus Diseases
Vaccines
Immunologic Factors
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on July 27, 2017