Rita 2009 schreef:
Evaluation of the safety and neutralizing activity of CL184, a monoclonal antibody cocktail against rabies, in a Phase II study in healthy adolescents and children
Auteurs / Authors / Autores
Beatrix Quiambao 2*, Alexander Bakker 1, N. N. Bermal 2, L.T. Sanchez 2, M.C.D. Ambas 2, C.P. Python 3, K. Hartmann 3, S. Marszalek 4, R. Grimaldi 1, C.E. Rupprecht 5, J. Goudsmit 1
* Pediatric infectious disease specialist and Chief, Clinical Research Division, Research Institute for Tropical Medicine, Philippines.
Her main research interest is rabies and she has conducted trials on rabies vaccines, immuneglobulins and monoclonal
antibodies. Other research interests include acute respiratory infections, maternal immunization, neonatal infections, snakebite and tetanus. She participated in the 1996 and 2004 WHO expert panel meetings and is a member of the Department of Health’s Technical Working group on Rabies and the Asian Rabies Expert Bureau.
In the developing world, children and adolescents are particularly at risk for rabies. This study evaluated the safety and neutralizing activity of CL184, a monoclonal antibody combination, in pediatric populations. CL184 is an equipotent mixture of two human IgG1 mAbs, which are directed against non-overlapping rabies virus glycoprotein epitopes. Non-exposed, healthy adolescents (12 to 18 years, N = 24) and children (5 to 11 years, N = 24) were recruited from an area with a high canine rabies endemicity in Metro Manila, Philippines.
Participants were randomized 2:1 to receive a single
dose of CL184 (20 IU / kg) or human rabies immunoglobulin (HRIG, Imogam(tm), 20 IU / kg) intramuscularly in combination with purified Vero rabies vaccine (Verorab(tm)) at days 0, 3, 7, 14 and 28, in a simulated rabies post-exposure prophylaxis setting. Adverse events, routine laboratory parameters, injection site reactions and rabies virus neutralizing activity (RVNA) using the rapid
fluorescence focus inhibition test (RFFIT) were evaluated. CL184 was well tolerated.
Comparative serology on rabies virus neutralizing activity was similar after administration of CL184 or HRIG; all participants reached levels of at least 0.5 IU / mL at Day 14.
In summary, this pediatric study confirmed
the safety and neutralizing activity profile as observed previously in adults and thus supports the
further development of CL184, including in pediatric populations at risk of rabies exposure.