A pooled analysis of continued prophylactic efficacy of quadrivalent human papillomavirus (types 6/11/16/18) vaccine against high-grade cervical and external genital lesions

Quadrivalent human papillomavirus (HPV) vaccine has been shown to provide protection from HPV 6/11/16/18-related cervical, vaginal, and vulvar disease through 3 years. We provide an update on the efficacy of the quadrivalent HPV vaccine against high-grade cervical, vaginal, and vulvar lesions based...

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Autores:
Tipo de recurso:
Fecha de publicación:
2009
Institución:
Universidad del Rosario
Repositorio:
Repositorio EdocUR - U. Rosario
Idioma:
eng
OAI Identifier:
oai:repository.urosario.edu.co:10336/23636
Acceso en línea:
https://doi.org/10.1158/1940-6207.CAPR-09-0031
https://repository.urosario.edu.co/handle/10336/23636
Palabra clave:
Virus DNA
Wart virus vaccine
Adolescent
Adult
Age distribution
Article
Cancer immunization
Cancer prevention
Clinical trial
Controlled clinical trial
Controlled study
Drug efficacy
Drug withdrawal
Female
Follow up
Human
Human papillomavirus type 11
Human papillomavirus type 16
Human papillomavirus type 18
Human papillomavirus type 6
Major clinical study
Multicenter study
Papanicolaou test
Phase 3 clinical trial
Priority journal
Randomized controlled trial
Sexual behavior
Smoking
Unspecified side effect
Uterine cervix cancer
Vagina cancer
Virus detection
Vulva cancer
Adolescent
Adult
Cancer Vaccines
Cervical Intraepithelial Neoplasia
Female
Human papillomavirus 11
Human papillomavirus 16
Human papillomavirus 18
Human papillomavirus 6
Humans
Multicenter Studies as Topic
Papillomavirus Infections
Papillomavirus Vaccines
Randomized Controlled Trials as Topic
Uterine Cervical Neoplasms
Young Adult
Female
Phase III as Topic
Clinical Trials
Genital Diseases
Rights
License
Abierto (Texto Completo)
Description
Summary:Quadrivalent human papillomavirus (HPV) vaccine has been shown to provide protection from HPV 6/11/16/18-related cervical, vaginal, and vulvar disease through 3 years. We provide an update on the efficacy of the quadrivalent HPV vaccine against high-grade cervical, vaginal, and vulvar lesions based on end-of-study data from three clinical trials. Additionally, we stratify vaccine efficacy by several baseline characteristics, including age, smoking status, and Papanicolaou (Pap) test results. A total of 18,174 females ages 16 to 26 years were randomized and allocated into one of three clinical trials (protocols 007, 013, and 015). Vaccine or placebo was given at baseline, month 2, and month 6. Pap testing was conducted at regular intervals. Cervical and anogenital swabs were collected for HPV DNA testing. Examination for the presence of vulvar and vaginal lesions was also done. Endpoints included high-grade cervical, vulvar, or vaginal lesions (CIN 2/3, VIN 2/3, or ValN 2/3). Mean follow-up time was 42 months post dose 1. Vaccine efficacy against HPV 6/11/16/18-related high-grade cervical lesions in the per-protocol and intention-to-treat populations was 98.2% [95% confidence interval (95% CI), 93.3-99.8] and 51.5% (95% CI, 40.6-60.6), respectively. Vaccine efficacy against HPV 6/11/16/18-related high-grade vulvar and vaginal lesions in the per-protocol and intention-to-treat populations was 100.0% (95% CI, 82.6-100.0) and 79.0% (95% CI, 56.4-91.0), respectively. Efficacy in the intention-to-treat population tended to be lower in older women, women with more partners, and women with abnormal Pap test results. The efficacy of quadrivalent HPV vaccine against high-grade cervical and external anogenital neoplasia remains high through 42 months post vaccination. ©2009 American Association for Cancer Research.