Evidence map›Paper›PMID 36477981›Full record

ArticleJournal of travel medicine2023

Immunogenicity and 1-year boostability of a three-dose intramuscular rabies pre-exposure prophylaxis schedule in adults receiving immunosuppressive monotherapy: a prospective single-centre clinical trial.

Hannah M Garcia Garrido, Bridget van Put, Sanne Terryn, Cornelis A de Pijper, Cornelis Stijnis, Geert R D'Haens, Phyllis I Spuls, Marleen G van de Sande, Steven van Gucht, Martin P Grobusch and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Journal of travel medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Guideline
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 2 countries.

Hannah M Garcia GarridoAmsterdam UMC, Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam 1081 HZ, The  Netherlands.ORCID 0000-0002-2244-9031
Bridget van PutAmsterdam UMC, Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam 1081 HZ, The  Netherlands.
Sanne TerrynSciensano, Brussels 1050, Belgium.ORCID 0000-0002-5524-9984
Cornelis A de PijperAmsterdam UMC, Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam 1081 HZ, The  Netherlands.
Cornelis StijnisAmsterdam UMC, Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam 1081 HZ, The  Netherlands.
Geert R D'HaensAmsterdam UMC, Department of Gastroenterology, University of Amsterdam, Amsterdam 1081 HZ, The  Netherlands.
Phyllis I SpulsAmsterdam UMC, Department of Dermatology, University of Amsterdam, Amsterdam 1081 HZ, The  Netherlands.
Marleen G van de SandeAmsterdam UMC, Department of Rheumatology and Clinical Immunology, University of Amsterdam, Amsterdam 1081 HZ, The  Netherlands.
Steven van GuchtSciensano, Brussels 1050, Belgium.
Martin P GrobuschAmsterdam UMC, Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam 1081 HZ, The  Netherlands.
Abraham GoorhuisAmsterdam UMC, Center for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam 1081 HZ, The  Netherlands.
Amsterdam University Medical Centers · NLSciensano (Belgium) · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor immunocompromised patients (ICPs), administration of rabies immunoglobulins (RIG) after exposure is still recommended regardless of prior vaccination, due to a lack of data. We aimed to assess the 1-year boostability of a three-dose rabies pre-exposure prophylaxis (PrEP) schedule in individuals using immunosuppressive monotherapy.

methodsIn this prospective study, individuals on immunosuppressive monotherapy with a conventional immunomodulator (cIM) or a TNF-alpha inhibitor (TNFi) for a chronic inflammatory disease received a three-dose intramuscular PrEP schedule (days 0,7,21-28) with 1 mL Rabipur®, followed by a two-dose simulated post-exposure prophylaxis (PEP) schedule (days 0,3) after 12 months. Rabies neutralizing antibodies were assessed at baseline, on day 21-28 (before the third PrEP dose), day 60, month 12 and month 12 + 7 days. The primary outcome was 1-year boostability, defined as the proportion of patients with a neutralizing antibody titre of ≥ 0.5 IU/mL at month 12 + 7 days. Secondary outcomes were geometric mean titres (GMTs) and factors associated with the primary endpoint.

resultsWe included 56 individuals, of whom 52 completed the study. The 1-year boostability was 90% (47/52) with a GMT of 6.16 (95% CI 3.83-9.91). All participants seroconverted at some point in the study. Early response to PrEP (at day 21-28) was significantly associated with 100% boostability (Odds Ratio 51; 95% confidence interval [5.0-6956], P < 0.01). The vaccination schedule was safe and well tolerated. No vaccine-related serious adverse events occurred.

conclusionIn patients using immunosuppressive monotherapy, a three-dose rabies PrEP schedule followed by a two-dose PEP schedule is immunogenic, with all patients seroconverting at some point in the study. Although boostability 7 days after PEP was not 100%, nobody would wrongly be denied RIG when only administered to those who responded early to PrEP while reducing the administration of RIG by 73%.

Indexed as

Pre-Exposure ProphylaxisRabiesRabies VaccinesAdultAntibodies, NeutralizingAntibodies, ViralHumansImmunization ScheduleImmunosuppressive AgentsPost-Exposure ProphylaxisProspective StudiesAntibodies, NeutralizingAntibodies, ViralImmunosuppressive AgentsRabies Vaccinesboostabilityimmunocompromised hostpreexposure prophylaxisrabiesschedulevaccine

Identifiers

PMID36477981
PMCPMC10075057
OpenAlexW4310944830

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.