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Pepin S, Nicolas JF, Szymanski H, Leroux-Roels I, Schaum T, Bonten M, Icardi G, Shrestha A, Tabar C. Immunogenicity and safety of a quadrivalent high-dose inactivated influenza vaccine compared with a standard-dose quadrivalent influenza vaccine in healthy people aged 60 years or older: a randomized Phase III trial. Hum Vaccin Immunother 2021; 17:5475-5486. [PMID: 34714720 PMCID: PMC8903946 DOI: 10.1080/21645515.2021.1983387] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A quadrivalent high-dose inactivated influenza vaccine (IIV4-HD) is licensed for adults ≥65 y of age based on immunogenicity and efficacy studies. However, IIV4-HD has not been evaluated in adults aged 60–64 y. This study compared immunogenicity and safety of IIV4-HD with a standard-dose quadrivalent influenza vaccine (IIV4-SD) in adults aged ≥60 y. This Phase III, randomized, modified double-blind, active-controlled study enrolled 1,528 participants aged ≥60 y, randomized 1:1 to a single injection of IIV4-HD or IIV4-SD. Hemagglutination inhibition (HAI) geometric mean titers (GMTs) were measured at baseline and D 28 and seroconversion assessed. Safety was described for 180 d after vaccination. The primary immunogenicity objective was superiority of IIV4-HD versus IIV4-SD, for all four influenza strains 28 d post vaccination in participants aged 60–64 and ≥65 y. IIV4-HD induced a superior immune response versus IIV4-SD in terms of GMTs in participants aged 60–64 y and those aged ≥65 y for all four influenza strains. IIV4-HD induced higher GMTs in those aged 60–64 y than those aged ≥65 y. Seroconversion rates were higher for IIV4-HD versus IIV4-SD in each age-group for all influenza strains. Both vaccines were well tolerated in participants ≥60 y of age, with no safety concerns identified. More solicited reactions were reported with IIV4-HD than with IIV4-SD. IIV4-HD provided superior immunogenicity versus IIV4-SD and was well tolerated in adults aged ≥60 y. IIV4-HD is assumed to offer improved protection against influenza compared with IIV4-SD in adults aged ≥60 y, as was previously assessed for adults aged ≥65 y.
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Affiliation(s)
- Stephanie Pepin
- Global Clinical Sciences, Sanofi Pasteur, Marcy L'Etoile, France
| | - Jean-François Nicolas
- Clinical Immunology & Allergology Department, Centre Hospitalier Lyon-Sud, Lyon, France
| | - Henryk Szymanski
- Paediatrics, St Hedwig of Silesia Hospital Trzebnica, Prusicka, Trzebnica, Poland
| | | | | | - Marc Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Giancarlo Icardi
- Department of Health Sciences, Ospedale Policlinico S. Martino IRCCS, University of Genoa, Genoa, Italy
| | - Anju Shrestha
- Global Pharmacovigilance, Sanofi Pasteur, Swiftwater, PA, USA
| | - Cynthia Tabar
- Global Clinical Sciences, Sanofi Pasteur, Marcy L'Etoile, France
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Dandona P, Mathieu C, Phillip M, Hansen L, Tschöpe D, Thorén F, Xu J, Langkilde AM, Proietto J, Stranks S, Chen R, O'Neal D, Pape A, Forbes M, Morbey C, Luger A, Hanusch U, Schnack C, Fliesser-Goerzer E, Hoelzl B, Ebenbichler C, Prager R, Van Gaal L, Vercammen C, Scheen A, Mathieu C, Duyck F, Nobels F, Ruige J, Aggarwal N, Woo V, St-Pierre B, Dumas R, Hramiak I, Elliott T, Hansen TK, Henriksen JE, Gram J, Lihn A, Bruun J, Saltevo J, Taurio J, Strand J, Valle T, Nieminen S, Pietilainen K, Guerci B, Hadjadj S, Cariou B, Verges B, Borot S, Penfornis A, Tschöpe D, Schaum T, Marck C, Horacek T, Rose L, Klausmann G, Luedemann J, Appelt S, Aigner U, Goebel R, Behnke T, Ziegler AG, Peterfai E, Kerenyi Z, Oroszlan T, Kiss GG, Konyves L, Piros G, Phillip M, Mosenzon O, Shehadeh N, Adawi F, Wainstein J, Dotta F, Piatti P, Genovese S, Consoli A, Di Bartolo P, Mannucci E, Giordano C, Lapolla A, Aguilar C, Bazzoni Ruiz AE, Mondragon Ramirez G, Orozco EP, Stobschinski de Alba CA, Medina Pech CE, Garza Ruiz J, Sauque Reyna L, Llamas Esperon G, Nevarez Ruiz LA, Velazquez MV, Flores Lozano F, Gonzalez Gonzalez JG, Garcia-Hernandez PA, Araujo Silva R, Villeda-Espinosa E, Mistodie C, Popescu D, Constantin C, Nicolau A, Popa B, Timar R, Serafinceanu C, Pintilei E, Soto A, Gimenez M, Merino J, Morales C, Mezquita P, Jendle J, Tengmark BO, Eriksson J, Londahl M, Eliasson B, Gunstone A, Heller SR, Darzy K, Mansell P, Davies M, Reed R, Browne D, Courtney H, Turner W, Blagden M, McCrimmon R, Dandona P, Bergenstal R, Lane W, Lucas K, White A, Bao S, White J, Jantzi C, Rasouli N, Ervin W, Lewy-Alterbaum L, Handelsman Y, Miranda-Palma B, Cleland A, Fink R, Rodbard H, Nakhle S, Greenberg C, Schorr A, Bays H, Simmons D, Klein E, Kane L, Fishman N, Ipp E, Garg S, Bhargava A, Singh MZ, Rosenstock J, Thrasher J, Warren M, Young L, Aroda V, Pettus J, Liljenquist D, Busch R, Wise J, Kayne D, Biggs W. Efficacy and Safety of Dapagliflozin in Patients With Inadequately Controlled Type 1 Diabetes: The DEPICT-1 52-Week Study. Diabetes Care 2018; 41:2552-2559. [PMID: 30352894 DOI: 10.2337/dc18-1087] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/17/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study evaluated the long-term safety and efficacy of dapagliflozin as an adjunct to adjustable insulin in patients with type 1 diabetes and inadequate glycemic control. RESEARCH DESIGN AND METHODS DEPICT-1 (Dapagliflozin Evaluation in Patients With Inadequately Controlled Type 1 Diabetes) was a randomized (1:1:1), double-blind, placebo-controlled phase 3 study of dapagliflozin 5 mg and 10 mg in patients with type 1 diabetes (HbA1c 7.5-10.5% [58-91 mmol/mol]) (NCT02268214). The results of the 52-week study, consisting of the 24-week short-term and 28-week extension period, are reported here. RESULTS Of the 833 patients randomized into the study, 708 (85%) completed the 52-week study. Over 52 weeks, dapagliflozin 5 mg and 10 mg led to clinically significant reductions in HbA1c (difference vs. placebo [95% CI] -0.33% [-0.49, -0.17] [-3.6 mmol/mol (-5.4, -1.9)] and -0.36% [-0.53, -0.20] [-3.9 mmol/mol (-5.8, -2.2)], respectively) and body weight (difference vs. placebo [95% CI] -2.95% [-3.83, -2.06] and -4.54% [-5.40, -3.66], respectively). Serious adverse events were reported in 13.4%, 13.5%, and 11.5% of patients in the dapagliflozin 5 mg, 10 mg, and placebo groups, respectively. Although hypoglycemia events were comparable across treatment groups, more patients in the dapagliflozin groups had events adjudicated as definite diabetic ketoacidosis (DKA; 4.0%, 3.4%, and 1.9% in dapagliflozin 5 mg, 10 mg, and placebo groups, respectively). CONCLUSIONS Over 52 weeks, dapagliflozin led to improvements in glycemic control and weight loss in patients with type 1 diabetes, while increasing the risk of DKA.
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Affiliation(s)
- Paresh Dandona
- Department of Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Chantal Mathieu
- Clinical and Experimental Endocrinology, Universitair Ziekenhuis (UZ) Gasthuisberg, University of Leuven, Leuven, Belgium
| | - Moshe Phillip
- Institute for Endocrinology and Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Diethelm Tschöpe
- Department for Endocrinology, Diabetology and Gastroenterology, Heart and Diabetes Centre, Bad Oeynhausen, Germany, and Ruhr University Bochum, Bochum, Germany
| | | | - John Xu
- AstraZeneca, Gaithersburg, MD
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Mathieu C, Dandona P, Gillard P, Senior P, Hasslacher C, Araki E, Lind M, Bain SC, Jabbour S, Arya N, Hansen L, Thorén F, Langkilde AM, Luquez C, Manghi FP, Ulla MR, Moisello MA, Visco V, De Lapertoza SG, Solis SE, Farias J, Sposetti G, Gillard P, Abrams P, van Ypersele de Strihou M, Conway J, Pedersen S, Senior P, Liutkus JF, Yip CE, Punthakee Z, Bernier F, Lochnan H, Woo V, Elliott T, Palma J, Merino CS, Vargas AD, Wendisch U, Reichel A, Seufert J, Becker B, Alawi H, Birkenfeld AL, Hasslacher C, Luedemann J, Schaum T, Marck C, Sauter J, Aigner U, Onishi Y, Seino H, Sato Y, Nunoi K, Yamauchi A, Nakashima E, Ikeda H, Shiraiwa T, Yamasaki Y, Yokoyama H, Nakamura K, Noritake M, Miyauchi S, Hakoda T, Hirohata Y, Hasegawa A, Fukumoto Y, Nagashima H, Takihata M, Kamada T, Jinnouchi H, Ono Y, Watanabe T, Ohashi H, Takai M, Seguchi T, Yamazaki K, Maeda H, Iwasaki S, De Valk H, Kooy A, Landewe-Cleuren S, Madziarska K, Stankiewicz A, Wasilewska K, Rudofsky G, Malecki M, Pankowska E, Szyprowska E, Lukaszewicz M, Tokarska L, Bondar I, Karpova I, Ruyatkina L, Zalevskaya A, Sardinov R, Khalimov Y, Sjoberg F, Koskinen P, Curiac D, Lind M, Bach-Kliegel B, Schultes B, Issa BG, Kilvert A, Pereira O, Bain S, Mishra B, Bhatnagar D, Chuck L, Gorson D, Robertson D, Casaubon L, Chaykin L, Frias JP, Hsia S, Jenders R, Lerman S, Segel S, Weissman P, Chang A, Reed J, Madu IJ, Bressler P, Abbott L, Gangi S, Wheeler K, Cohen K, Biggs W, Jabbour S, Karounos D, Menon S, Miers W, Aleppo G, Lefebvre G, Sugimoto D, Ferraro R, Kelly R, Twahirwa M, Case C, Klonoff D, Denker P, Hollander P, Welch M, Leinung M, Kotek L, McGill J, Shlesinger Y, Huffman C, Aronoff S, Lorber D, Terrelonge A, Akhrass F, Bredefeld C, Hershon K, Lenhard J, Donovan D, Stonesifer L, Greenberg C, Ipp E, Bhargava A, Bao S. Efficacy and Safety of Dapagliflozin in Patients With Inadequately Controlled Type 1 Diabetes (the DEPICT-2 Study): 24-Week Results From a Randomized Controlled Trial. Diabetes Care 2018; 41:1938-1946. [PMID: 30026335 DOI: 10.2337/dc18-0623] [Citation(s) in RCA: 171] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/18/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This 24-week, double-blinded, phase 3 clinical trial (DEPICT-2; ClinicalTrials.gov, NCT02460978) evaluated efficacy and safety of dapagliflozin as adjunct therapy to adjustable insulin in patients with inadequately controlled type 1 diabetes (HbA1c 7.5-10.5%). RESEARCH DESIGN AND METHODS Patients were randomized 1:1:1 to dapagliflozin 5 mg (n = 271), dapagliflozin 10 mg (n = 270), or placebo (n = 272) plus insulin. Insulin dose was adjusted by investigators according to self-monitored glucose readings, local guidance, and individual circumstances. RESULTS Baseline characteristics were balanced between treatment groups. At week 24, dapagliflozin significantly decreased HbA1c (primary outcome; difference vs. placebo: dapagliflozin 5 mg -0.37% [95% CI -0.49, -0.26], dapagliflozin 10 mg -0.42% [-0.53, -0.30]), total daily insulin dose (-10.78% [-13.73, -7.72] and -11.08% [-14.04, -8.02], respectively), and body weight (-3.21% [-3.96, -2.45] and -3.74% [-4.49, -2.99], respectively) (P < 0.0001 for all). Mean interstitial glucose, amplitude of glucose excursion, and percent of readings within target glycemic range (>70 to ≤180 mg/dL) versus placebo were significantly improved. More patients receiving dapagliflozin achieved a reduction in HbA1c ≥0.5% without severe hypoglycemia compared with placebo. Adverse events were reported for 72.7%, 67.0%, and 63.2% of patients receiving dapagliflozin 5 mg, dapagliflozin 10 mg, and placebo, respectively. Hypoglycemia, including severe hypoglycemia, was balanced between groups. There were more adjudicated definite diabetic ketoacidosis (DKA) events with dapagliflozin: 2.6%, 2.2%, and 0% for dapagliflozin 5 mg, dapagliflozin 10 mg, and placebo, respectively. CONCLUSIONS Dapagliflozin as adjunct therapy to adjustable insulin in patients with type 1 diabetes was well tolerated and improved glycemic control with no increase in hypoglycemia versus placebo but with more DKA events.
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Affiliation(s)
- Chantal Mathieu
- Clinical and Experimental Endocrinology, University of Leuven, Leuven, Belgium
| | - Paresh Dandona
- Department of Medicine, State University of New York at Buffalo, Buffalo, NY
| | - Pieter Gillard
- Clinical and Experimental Endocrinology, University of Leuven, Leuven, Belgium
| | - Peter Senior
- Division of Endocrinology, University of Alberta, Edmonton, Canada
| | | | - Eiichi Araki
- Department of Metabolic Medicine, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Marcus Lind
- Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Medicine, NU Hospital Group, Uddevalla, Sweden
| | - Stephen C. Bain
- Diabetes Research Unit, Swansea University, Swansea, Wales, U.K
| | - Serge Jabbour
- Division of Endocrinology, Diabetes and Metabolic Diseases, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
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Krueger K, Kellner H, Welcker M, Schaum T, Haug-Rost I. THU0130 Adherence to DMARDS in Patients with Rheumatoid Arthritis - A Multicenter Outpatient Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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