美國大學2015開始的試驗,抗瘧疾藥物對狂犬病疫苗的影響,認為與其他兩種藥物相比,氯喹有明顯抑製抗體的作用。
美國大學2015開始的試驗,抗瘧疾藥物對狂犬病疫苗的影響,認為與其他兩種藥物相比,氯喹有明顯抑製抗體的作用。
Effect of Antimalarial Drugs to Rabies Vaccine for Post-exposure Prophylaxis. (MALRAB)
https://clinicaltrials.gov/ct2/show/results/NCT02564471
Effect of Antimalarial Drugs on the Immune Response to Intramuscular Rabies Vaccination Using a Postexposure Prophylaxis Regimen
- PMID: 31743394
- DOI: 10.1093/infdis/jiz558
Abstract
Background: Chloroquine can impair the immune responses to intradermal rabies vaccination. Current guidelines recommend an extra intramuscular dose be given for postexposure prophylaxis in previously unvaccinated persons taking any antimalarial drug.
Methods: We conducted a randomized, open-label, single-site study in 103 previously unvaccinated healthy adults age ≥18 to ≤60 years old to evaluate the effects of chloroquine, atovaquone/proguanil (Malarone), and doxycycline on the antibody response to a purified chick embryo cell vaccine, given on a postexposure prophylaxis schedule. All treatment groups received antimalarials 14 days prior to and during vaccination.
Results: All subjects achieved accepted neutralizing antibody titers of ≥0.5 IU/mL following the second rabies vaccination dose and maintained this protection through the duration of the study. We observed a reduction in rabies antibody geometric mean titer in the chloroquine versus control groups 28 days after vaccination: 2.3 versus 6.87 IU/mL, respectively (P < .001, t test). A significant difference was not observed for those taking Malarone or doxycycline.
Conclusions: We conclude that there is no reduction of rabies antibody response in subjects taking Malarone or doxycycline, but a significant reduction in those taking chloroquine; however, accepted antibody levels were achieved for all 3 antimalarials.
Clinical trials registration: NCT02564471.
Keywords: antimalarial drugs; prophylaxis; rabies; vaccination.
https://pubmed.ncbi.nlm.nih.gov/31743394/